RX 81 
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RX 81 
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LIBRARY OF CONGRESS. 

"* a v/ <?- — \ 

Chap..'.!.; "Copyright No, 

Shelf_.JiA.5 



UNITED STATES OF AMERICA. 



ERR ATA . 



Page 26, fifth line from end of note, for 95 read 97. 

Page 29, sixteenth line from end of note, for 96, 97, 98 
read 94, 95, 96. 

Page 59, at end of note, for footnote on page' '04, read 
footnote \ on page g6. 

Page 70. A dotted line should connect "The whole of 
materia medica pura " with "Homoeopathy," just as a dotted 
line connects part of the science side of the table with " Ra- 
tional practice" on the art side. 

Page 79, in note, for footnote o?i pages Q4 and oj read 
foohiote X on page gd. 



Principles of Medicine 



Designed for Use as a Text-book in Medical 

Colleges, and for Consideration by 

Practitioners Generally 



CHARLES S. MACK, M. D., 



One of the Professors of Materia Medica and 

Therapeutics in the Hahnemann Medical 

College and Hospital, Chicago. 



Recently Professor of Materia Medica and Therapeutics in the 

Homoeopathic Medical College in the University of Michigan. 

at Ann Arbor. 




Chicago: 

The W. T. Keener Company 

1897. 






Copyright, 1897. 
C. S. Mack. 



PREFACE. 



The object of this book is to show just what is 
the cure sought in any given practice of homoe- 
opathy — to show that that cure cannot be intelli- 
gently attempted excepting under guidance of 
sitnilia similibus carantur as law, and to show that 
one may consistently accept homoeopathy and at the 
same time accept whatever else is good in medicine. 
Definition of the end sought in any given practice of 
homoeopathy is here recognized as essential to the 
most satisfactory exposition of homoeopathy's claim; 
such definition occurs and recurs throughout the 
book, and is never lost sight of. 

Rational practice is here defined, and something 
is shown of wherein lies its strength, and wherein 
lie its limitations. 

Empiricism is discussed: wherein lies its essen- 
tial feebleness is shown, while at the same time 



IV. PREFACE. 

reason is given for believing that we can never 
entirely outgrow the practice of empiricism. 

Numbers I, II and IX of the contents are revised 
from Philosophy in Homoeopathy. In that book, as 
in its predecessor Similia Similibus Curanturf, 
something was offered as positive argument in favor 
of Homoeopathy, but it is here omitted, because 
based upon premises which can not be assumed or, 
with propriety, discussed in the class-room of a 
medical college, — and as a text-book in the colleges 
this present book is intended. The only argument 
here offered in favor of homoeopathy is one by 
exclusion. 

It is hoped that Principles of Medicine will 
prove of interest to practitioners as well as to 
undergraduates. 



CONTENTS. 



I. Is Homoeopathy Exclusive ? (Extract from a Letter 

to a Physician), .... 9 

II. Homoeopathy the Only System of Curative Medi- 
cine. (Two Lectures delivered in the Homoe- 
opathic Medical College in the University of 
Michigan), . . .15 

III. What Shall We Prove ? 39 

IV. Homoeopathy Menaced by Empiricism. (A Paper 

presented at the 1891 Meeting of the Minnesota 
Institute of Homoeopathy), . . .43 

V. Empiricism — Rational Practice — Practice under 

Guidance of Law, .... 49 

VI. How to Study and How to Teach Materia Medica. 
(A Paper presented at the 1895 Meeting of the 
American Institute of Homoeopathy), . 75 

VII. Need of Definition of the End Sought in any Given 
Practice of Homoeopathy. (A Paper presented 
at the 1895 Meeting of the Homoeopathic Med- 
ical Society of the State of Michigan), . 89 
VIII. Some Considerations Bearing upon Practice with 
Dynamic Antagonists in Cases of Poisoning by 
Dynamic Drugs, . . . -93 
IX An Address to Some Students in a Non-Homoe- 
opathic Medical College, 103 
(v) 



I. 

IS HOMOEOPATHY EXCLUSIVE? 



EXTRACT FROM A LETTER TO A PHYSICIAN. 



IS HOMOEOPATHY EXCLUSIVE? 



[Extract from a Letter to a Physician.] 

Dr. Blank held in his paper, as I understood 
him, that homoeopathists should not bar out treat- 
ment which is useful though not homoeopathic. I 
said that I most cordially sympathized with Dr. Blank 
in the position which he had taken. I said, more- 
over, that I was equally cordial in my sympathy 
with those who insist that there cannot possibly be 
any law of cure other than si??iilia. I said, there is 
no inconsistency in the statement that I most cor- 
dially sympathize both with Dr. Blank and with those 
who lay stress on similia^s being the only law of cure. 
The explanation of any apparent inconsistency here 
would be arrived at by accurately defining the word 
cure. Having thus denned cure, we should, I think, 



IO PRINCIPLES OF MEDICINE. 

be in a position to maintain that no treatment not 

homoeopathic can be curative — that as a system of 

curative medicine homoeopathy is exclusive; but it 

does not follow that there may not be indefinitely 

many principles (concerning which similia says 

nothing) upon which one can base useful, though 

not curative, treatment. Upon one or another such 

principle (concerning which similia says nothing) 

one proceeds when he gives morphine as an anodyne; 

when he gives iron or lime to supply a deficiency of 

that ingredient in blood or other tissue; or when with 

germicides or parasiticides he directly attacks germs 

or parasites which have been introduced from without 

into wounds or into the alimentary canal. 

In some circumstances it may be equally feasible 

and equally useful either to cure your patient homoe- 

opathically or to relieve him by useful, though 

non-homoeopathic and non-curative, treatment. To 

illustrate,* let us suppose that he is afflicted with an 

intestinal parasite, and let us suppose further that 

the parasite's continued presence depends upon some 

unhealthiness of the patient. If, guided by your 

patient's symptoms, you administer a homoeopathic 

*This is simply for the sake of illustration. I am not ad- 
vocating homoeopathic treatment as efficient against intestinal 
parasites. We could as well draw illustration from germ dis- 
eases. See pp. 17, 18 and 113 to 116 of this book. 



IS HOMOEOPATHY EXCLUSIVE r* II 

remedy, and as a result of this he discharges the 
parasite,, you will have cured your patient. If, on 
the other hand, you directly attack the parasite with 
parasiticides and kill it, your patient, relieved of the 
proximate cause of his illness, may recover. In the 
first instance you will have treated your patient and 
cured him; in the second instance you will not, in 
the same sense, have treated your patient — you will 
have directly attacked the parasite, and your patient 
will not have been, in the same sense, cured — he will 
have recovered: in either instance a result is that 
your patient, whereas he was ill, is well. This, of 
course, assumes that you have not with the parasiti- 
cide harmed your patient. 

Many other illustrations might be given of the 
fact that a patient may become well as a result of 
non-curative treatment. On the other hand may not 
the result of curative treatment be something short 
of health ? I may attempt to cure a patient with 
valvular disease of the heart, or with chronic 
nephritis, expecting never to see him well, but hoping 
to effect improvement which will in kind be cure. 

All this suggests a sliding scale. Of two men 
who agree that similia is the only law of cure one 
may attempt homoepathic treatment in almost every 
case, while the other rarely attempts it. 



II. 

HOMCEOPATHYTHE ONLY SYSTEM 
OF CURATIVE MEDICINE. 



[Two Lectures delivered in the Homoeopathic Medical College in the 

University of Michigan. Reprinted from the Medical Era 

for November, 1889.] 



II. 



HOMOEOPATHY THE ONLY SYSTEM OF 
CURATIVE MEDICINE. 



I. 

We enter to-day upon a course of study in 
materia medica and therapeutics. Before taking 
up the study of individual drugs, let us map out 
the field in which our work is to be done; and I ask 
your very particular attention to these introductory 
remarks, for I believe that an intelligent understand- 
ing of them will be of the greatest value to you as 
students in the various departments of medical 
science, as practitioners, and as supporters of 
homoeopathy and whatever else is good in medical 
science and in the art of healing. 

Similia similibus cur ant ur is the law and the only 
possible law of cure — as a system of curative medi- 
cine homoeopathy is exclusive; but there are various 
(15) 



1 6 PRINCIPLES OF MEDICINE. 

principles (concerning which similia says nothing) 
upon which useful, though not curative, treatment 
may be based. I am careful to call similia similibus 
curantur a law and not a rule. Men make rules, 
but a law of nature is not man-made and exists in 
the very nature of things; such a law I believe 
similia similibus curantur to be. 

To understand this statement — that as a system 
of curative medicine homoeopathy is exclusive, but 
that there are various principles upon which useful, 
though not curative, treatment may be based — you 
must first know precisely what we mean by each of 
the words homoeopathy and cure. 

The word homoeopathy Qo/jlolos, like, and irddos, affec- 
tion or morbid condition) by implication defines itself 
as simply a recognition of similia similibus curantur 
as law. Let us note, then, that the word homoeopathy 
and the law which it recognizes have reference to the 
quality only and not to the quantity of a medicine. 

We say that similia is the law and the only possi- 
ble law of cure. What, then, do we mean by cure? 
By cure we mean such modification of the quality of 
vital processes and their effects that, whereas these 
processes and effects are abnormal, they shall be- 
come normal (or approximately so), and this as the 
immediate effect of the medicine used. A drug can 



HOMOEOPATHY THE ONLY SYSTEM. 1 7 

be curative only by reason of its dynamic effect 
upon the patient. Curative treatment is invariably 
a treatment of the patient and never a direct attack 
upon a proximate cause of disease. We shall pres- 
ently return to this subject of homoeopathy and cure. 
Let us now speak of some principles upon which 
we can base useful though non-curative treatment. 
In our care of patients we should observe the 
principles of hygiene. These are alike applicable 
in the care of the sick and the care of the well. In 
directing what exercise a patient shall take and what 
clothing he shall wear, we are, of course, outside 
the field of medicine. There are, however, certain 
instances in which treatment is called medical, 
though based upon principles identical with those 
of hygiene. A simple instance of this kind is where 
the larvae of intestinal parasites have been intro- 
duced in measly pork or other meat into the alimen- 
tary canal. It is the business of the hygienist to see 
that no such larvae be introduced, and that in the 
proper cooking of meat any larvae possibly present 
be killed before the meat is eaten. If, however, 
living larvae have been introduced, and from them 
develop parasites whose presence in the alimentary 
canal is the occasion of their victim's illness, it is 
proper to directly attack those parasites by putting 



1 8 PRINCIPLES OF MEDICINE. 

into the patient's alimentary canal any substance 
which will destroy the parasites without harming the 
patient. This treatment we call medical, but it is 
based upon a principle identical with one of hygiene. 
In the supposed case you do not treat your patient 
at all; you directly attack a proximate cause of his 
illness, and when that cause is removed he will 
probably recover. This is one illustration of treat- 
ment which is useful, but not curative. It may be 
taken as typical of all instances in which it is feasi- 
ble to directly attack parasites on the skin, in the 
skin or in any part of the body and destroy them 
without harming the patient. 

After the foregoing remarks there is perhaps no 
occasion for making special mention, in this con- 
nection, of the germ theory of disease and practice 
based upon it. To immediately attack and destroy 
disease germs in an open wound or any place in the 
body without harming the patient may be useful, but 
is not curative, treatment. If, instead of bacteria, 
ptomaines becomes the direct object of our attack, 
we shall still be no nearer to curative treatment. 
Whatever progress may be made in practice on this 
line, it can never afford a system of curative treat- 
ment, which I think you will plainly see when we 
come to speak again of homoeopathy and cure. 



HOMCEOPATHY THE ONLY SYSTEM. 1 9 

Let us take another example of treatment which 
we call medical, though it is based upon a principle 
identical with one of hygiene. If you examine the 
blood of an anaemic patient, and find that it contains 
less iron than does the blood of a person in health, 
it seems reasonable to supply that deficiency by 
having him take into his system more iron. If you 
regulate his diet so that he shall take food contain- 
ing an unusual amount of iron, you will not think of 
calling any part of his food medicine; if, however, 
you give him iron in a pill, that you will call medi- 
cine. The deficiency of iron in the blood of an 
anaemic patient is an effect of abnormality in vital 
processes. To simply supply that deficiency will not 
render those processes normal, and to render them 
normal is a requisite to cure. We have given here 
an illustration of what may be useful, though not 
curative, treatment. Various other substances may 
be given as medicine upon this same principle, i. e., 
to supply a deficiency resulting in tissues from ab- 
normality in vital processes.* A use of iron distinct 

* Drugs useful in some such way as this may be indefi- 
nitely many, — preparations of lime or phosphorus may be 
among them; quinine may be one, though it probably is not. 
[See H. C. Wood's Therapeutics : its Principles a?id Prac- 
tice, ninth edition, p. 639.] A curative medicine in such 
circumstances would immediately so modify the quality of 
vital processes that the deficiency, which is an effect of ab- 
normality in these processes, would not persist. 



20 PRINCIPLES OF MEDICINE. 

from the above may be where, by disease effects in 
an anaemic patient, it is indicated as homoeopathic 
and curative. 

Some substances which are used for the sake of 
their physical properties may be called medicine; as 
demulcent drinks. Possibly you would call protec- 
tive salves and also lubricants, medicine. Obviously, 
none of these things are curative. 

Certain substances are used as medicine for the 
sake of their chemical properties. If, as an effect 
of abnormality in vital processes, the gastric juice is 
too acid or not acid enough, you may, by putting 
into the stomach after meals an alkali or an acid, 
partially neutralize or else render more acid the 
juice, and thus help your patient. In neither case 
is the immediate object of the treatment mentioned 
to modify the quality of those vital processes to 
whose abnormality is due the variation from normal 
gastric juice. The treatment, therefore, is not cura- 
tive, though it may be useful. 

A word here in regard to stimulants pure and 
simple. Stimulants, as such, affect vital processes, 
both as to strength and as to rate or speed, but not 
as to quality. When these processes are weakened 
and threaten to entirely fail, you may, by stimulating 
them, bridge a patient over some critical period. 



HOMOEOPATHY THE ONLY SYSTEM. 2 1 

As stimulants do not immediately modify the quality 
of vital processes, they cannot be curative, though 
they may be immensely useful.* 

We have now cited a number of instances illustra- 
tive of useful non-curative treatment : in none of 
them does the treatment immediately modify the 
quality of vital processes in the patient, and that it 
should do so is one of the requisites to cure. Let us 
again take up the subject of cure and inquire how it 
may be effected. 

Cure involves a specified modification of vital 
processes. As these processes are in themselves un- 
knowable to inductive science, we cannot affect them 
in a specified way unless under guidance of a law 
which states the relation between certain facts in 
themselves knowable. 

It seems as if the knowable facts between which 

a law of cure would define the relation could not 

possibly be any other than, on the one hand, effects 

produced by the disease in question, and, on the 

' * If I correctly understand the action of alcohol and of 
digitalis upon the heart, the following will illustrate what I 
mean by a stimulant pure and simple. The heart-beats of a 
patient with pneumonia or typhoid fever may be affected as to 
strength and rate by alcohol, but not as to quality; — under 
the influence of alcohol the heart's action remains in quality 
that of pneumonia or typhoid fever and nothing else. 
Digitalis while affecting the strength and rate of heart-beats in 
such a patient affects also their quality. I take it that alcohol 
is a stimulant pure and simple, but that digitalis is not. 



22 PRINCIPLES OF MEDICINE. 

other hand, dynamic effects producible by an indi- 
cated drug or drugs taken in health.* 

The reason for thinking that a law of cure would 
speak of drugs as dynamic agents is, that to im- 
mediately modify the quality of vital processes is a 
requisite to cure. The reason for thinking that only 
in effects do vital processes (as modified by disease 
or drug) afford the knowable data of which a law of 
cure would speak is that, while to directly deal with 
a proximate .cause of disease is not curative, vital 
processes can be kjiown to inductive science only 
in proximate causes and in effects. 

Let us now inquire, What is the relation between 
unmodified disease effects and unmodified dynamic 
drug effects, which marks a drug as curative? Dr. 
J. P. Dakef has said that only four relations are 
conceivable in answer to this question, viz. : 
" i. The Antipathic — AvTi-wa0os — where the symp- 
toms, or conditions indicated by them, are 
opposites ; the relationship being one of 
direct antagonism. 



* Dynamic properties in a drug are those by reason of 
which it acts immediately upon vital processes. Physical or 
chemical examination does not touch upon dynamic properties 
in a drug, any more than does such examination of an animal 
organ touch upon vital processes. On dynamic properties see 
Pereira's Materia Medica and Therapeutics, third American 
edition, vol. I, pp. 135 to 138. 

\ Therapeutic Methods, pp. 88, 89. 



HOMCEOPATHY THE ONLY SYSTEM. 23 

" 2. The Allopathic — A\\os-7ra0os — where the symp- 
toms are different, the same organs and 
tissues being affected in a different manner, 
or other organs and tissues being affected in 
some manner ; the relationship being one of 
in defin ite dh • ers it\ • . 
"3. The Isopathic — lo-os-irados — where the symp- 
toms are identical, the same organs and 
tissues being affected, and in exactly the 
same manner ; the relationship being one of 
sameness or identity. 
"4. The Homceopathic — *OnoLos-irados — where the 
symptoms are similar, the same organs and 
tissues being affected in a like manner \ the 
relationship being one of similarity, and not 
identity. 
Dr. Dake has practically included in this list of 
four all the possible relations, and he has included 
more. What he speaks of as the allopathic relation 
is really no relation at all. In passing, it is obvious 
that the law of cure cannot require simply that a 
drug to be curative must be capable of producing 
pathogenetic effects unlike the disease effects pre- 
sent. Xo one believes in allopathy with the defini- 
tion here implied. 

There is in reality no isopathic relation, for 



24 PRINCIPLES OF MEDICINE. 

disease effects and drug effects cannot be identi- 
cal ] — no two things can by any possibility be 
identical. It is well enough to observe in this 
connection not only that isopathy is impossible, 
but that, if it were possible, its demand would be 
such as we could not practically meet. Under its 
sanction one remedy and only that particular remedy 
could be indicated in any given case, for identical 
is not a comparable adjective. Similar, however, is 
a comparable adjective, and similia recognizes that 
various drugs may be in various degrees curative in 
the same circumstances. 

II. 
We have now advanced to a point where we can 
say that the law of cure must define the antipathic or 
else the homoeopathic relationship as that by which 
we may recognize a drug as curative. Let us now 
consider what claim contraria co7ttrariis curantur 
might make to being the law of cure. What is the 
contrariety which contraria would exact? What is 
an antipathic drug? There are two distinct mean- 
ings with which we use the word opposite. We may 
say that one symptom is the opposite of another, 
meaning that the two vary in diametrically opposite 
directions from the standard found in health ; as 



HOMOEOPATHY THE ONLY SYSTEM. 25 

when we say that a too rapid heart action is the 
opposite of a too slow, or that the condition of a con- 
tracted capillary is the opposite to that of a dilated 
one, or that a temperature above normal is the 
opposite of a temperature below normal. Disease 
effects of which such opposites can obtain seem com- 
paratively few, and probably there is no disease of 
which, taken as a whole, such an opposite can be 
predicated. What, in this sense, are the opposites 
of itching, nausea, headache, inflammation, fatty or 
other degeneration, rheumatism, pneumonia, typhoid 
fever? The fact seems to be that there are none. 
Where such opposites do obtain they seem to be 
opposites in a very general way only. What particu- 
lar opposite would the following particulars indicate 
in a given case of diarrhoea?: blackish stool after 
which there is a griping pain in the umbilical region 
— associated with this diarrhoea is a pressive frontal 
headache with blurring of vision — the headache and 
blurring disappear when head is tightly bound. I do 
not see that any one of these particulars (simply as 
here stated, and without theory as to how it was 
brought about) could serve as an indication under 
contraria contrariis curantur. * Dr. Carroll Dun- 



* By way of contrast note that, theoretically at least, each 
particular of the diarrhoea supposed might serve as an indica- 
tion for a homoeopathic remedy. 



26 PRINCIPLES OF MEDICINE. 

ham* is right in thinking that a law of cure implies 
a capability of endless development in the drug 
science which it recognizes, and we see that there 
would be no such thing as a science of drug con- 
traries capable of endless development. We con- 
clude that contraria contrariis curantur cannot be 
the law of cure, if the oppositeness which it would 
exact be such as we have here defined and illus- 
trated, f 

We said that the word opposite is used with two 
distinct meanings. We find it impossible to regard 
contraria contrariis curantur as the law of cure, if by 
opposites we mean effects varying in diametrically 
opposite directions from the standard found in health. 
Using opposite with its other meaning we may say 
that health is the opposite of any disease, and that 

* Homoeopathy the Science of Therapeutics, p. 13. 

f Contraria contrariis opponenda is an entirely different 
thing from contraria contrariis curantur whose claim to 
being the law of cure we have been considering. It may at 
times be well to forcibly oppose or antagonize contraries with 
contraries {contraria contrariis opponenda), but there is no 
need of a law under which to do that, and I do not know that 
contraria contrariis opponenda purports to be a law of 
nature — it is simply a rule sometimes applicable in rational 
practice; and the result of practice with dynamic drugs under 
this rule is not cure, for the immediate resultant of two ab- 
normal forces (that of disease and that of the pathogenetic 
properties in a drug) cannot be health. See on p. 95 of this 
book what is said of a pupil dilated with a mydriatic and then 
contracted with a myotic — also what is said in foot-note on p. 
29 as to the impossibility of radically blotting out disease effects 
with antagonistic dynamic drugs. 



HOMOEOPATHY THE ONLY SYSTEM. 27 

in health is found the opposite of any symptom. If 
this latter is the meaning with which we are to use 
the word opposite, co7iti'aria demands that a curative 
drug must be one which taken in health would pro- 
duce health. The reductio ad absurdum is complete. 

Having first demonstrated that cure cannot be 
intelligently undertaken unless under guidance of a 
law denning the relation between unmodified disease 
effects and unmodified dynamic drug effects, we have 
now by exclusion demonstrated that no relation 
other than that of similarity can be the one denned 
by that law. We are thus obliged either to fix our 
belief in swiilia as the law, and the only possible law, 
of cure, or else to give up all attempt to intelligently 
cure. 

Understand, please, precisely what this argument 
by exclusion has done for us. An argument by ex- 
clusion never proves anything unless something is 
assumed at the outset. We have assumed that there 
is such a thing as cure, and our argument has 
brought us to the conclusion that similia siinilibus 
curantur is the law of cure. One or another of you 
may say that our argument has been logical through- 
out, but that we are mistaken in the opinion that 
there is such a thing as cure. I think you will do 
well to regard this as a matter of opinion. We shall 



28 PRINCIPLES OF MEDICINE. 

continue upon the assumption that there is such a 
thing as cure.* 

A practical difficulty which may embarrass one 
in the treatment of some patients, perhaps very many 
patients, is that of inducing with drugs effects which 
resemble in any considerable degree those of many 
a disease. I think, though, that this difficulty need 
not deter one from accepting similia as law. Some 
patients may be incurable for aught similia says. 

* Hahnemann, in arguing for homoeopathy, discussed dy- 
namic drugs acting differently from the disease — those acting 
oppositely to the disease — and those acting similarly to the 
disease. See Vol. I, p. 10 of his Materia Medica Pura, trans- 
lated by Dr. Dudgeon, with annotations by Dr. Hughes; 1880. 

One who does not see that all possible relations be- 
tween disease effects and unmodified dynamic drug effects 
are included in 1 and 4 of Dr Dake's list may be helped by 
the following, which is a presentation in detail of, I think, all 
such relations conceivable. I think that in our search for the 
relation which the law of cure would define, we can eliminate 
the relations represented by starred lines, and that the only 
unstarred lines represent the relation defined by similia: — 

# 1. Drug capable of producing effects precisely opposite 
to the disease effects. 

•$2. Drug capable of producing effects similar to precise 
opposites of the disease effects. 

\k 3. Drug capable of producing the opposite, health. 

4. Drug capable of producing a condition similar to the 
opposite, health, and having some relation to the disease 
effects, but affording no similarity to effects opposite to those 
of the disease. 

& 5. Drug capable of producing effects identical with those 
of the disease. 

6. Drug capable of producing effects similar to those of 
the disease. 

Line 1 cannot represent the relation which the law of cure 
would define, because a drug capable of producing effects pre- 
cisely opposite to those of disease is as impossible as is an 



HOMOEOPATHY THE ONLY SYSTEM. 29 

Little has been done in the science of drug patho- 
genesy compared with what is still undone: the like 
might be said of any science. While similia is abso- 
lute and eternally the same, our ability to practice 
under its guidance will be ever greater and greater, 
as the sciences of disease effects and drug patho- 
genesy are developed. One of the best things that 
has ever been written on the subject of homoeopathy 
is Dr. Carroll Dunham's essay, "Homoeopathy the 
Science of Therapeutics;" and in that essay Dr. 
Dunham, having shown that the "Therapeutic Law," 
by which he means the law of cure, must define the 
relation between unmodified disease effects and un- 
modified dynamic drug effects, says truly that the 

isopathic drug. On isopathy see pp. 23, 24 of this book. Because 
precise oppositeness between disease effects and dynamic drug 
effects does not obtain, it is impossible to radically blot out 
disease effects with an antagonistic dynamic drug. See what 
is said on pages 96, 97, 98 upon the question of radical antag- 
onism between dynamic drugs. 

An antipathic relation which we have already considered 
under coyitrai'ia coyitrai'iis curantur, and eliminated (see pp. 
24, 25, 26), is really that here represented by line 2. 

There is no such drug as line 3 would exact, or line 5. 

The relation represented by line 6 has already been consid- 
ered and accepted as that which the law of cure must define. 

The relation represented by line 4 is the same as that rep- 
resented by line 6. It is evident that a drug capable of pro- 
ducing a condition similar to the opposite, health, is, if its 
effects bear any relation to those of the disease and are not 
similar to the opposites of these latter, homoeopathic; for any 
deviation from health in these drug effects involves, if they 
bear any relation to the disease effects, a similarity to these 
disease effects or to their opposites. 



30 PRINCIPLES OF MEDICINE. 

first condition of a science of therapeutics is that 
there be "a capability of infinite progress in each of 
its elements without detriment to its integrity as a 
whole." Let me say right here that when we speak 
of the science of homoeopathy we do not mean the 
practice of homoeopathy; the practice of homoeo- 
pathy — the practice of medicine or surgery in any of 
its departments; unless we except empiricism, is in- 
variably and inevitably an art. It is the principles 
and scientific facts upon which practice is based 
that constitute medical science; just as the building 
of bridges is an art, while the science of civil engi- 
neering comprises those principles and facts of 
science upon which the scientific bridge-builder 
proceeds, 

You now understand that a knowledge of two 
distinct sciences (the science of unmodified disease 
effects; and the science of unmodified dynamic drug 
effects) is absolutely essential to the practice of 
homoeopathy. 

The following are three ways in which the devel- 
opment of materia medica pura, i. <?., the science of 
unmodified dynamic drug effects in human beings, is 
effected: 

First. By acquisition of knowledge regarding 
hitherto unknown drugs. 



HOMCEOPATHY THE ONLY SYSTEM. 3 1 

Second. By acquisition of knowledge regarding 
hitherto unrecognized effects of drugs already known. 
Third. By the elimination of errors in the ma- 
teria medica pura as handed down to us, for it is not 
to be for an instant supposed that no errors of ob- 
servation have been committed by those who have 
worked at this science. 

Conspicuous as means toward the development 
of a knowledge of materia medica pura are experi- 
ments with drugs upon the lower animals, but the 
results of these experiments can never be accepted 
unquestioned as data upon which to base the cura- 
tive treatment of human beings; for the dynamic 
effects of a drug upon one of the lower animals are 
sometimes very different from its effects upon man, — 
moreover, as regards subjective effects, human be- 
ings alone can describe them. That some animals 
enjoy a partial or complete immunity from harmful 
effects of certain substances very poisonous to man 
is a fact with which you will become well acquainted. 
" Birds are peculiarly insusceptible to the action of 
opium or morphine."* "In their sensitiveness to 
atropine animals differ very much, and as a general 
rule, herbivora are less susceptible than carnivora. 

*Brunton's "Pharmacology, Therapeutics and Materia 
Medica," adapted to the United States Pharmacopoeia by 
Francis H. Williams, M. D., third edition, p. 851. 



32 PRINCIPLES OF MEDICINE. 

Thus the rabit may be fed for days entirely upon bel- 
ladonna leaves without injury, and many grains of 
atropine are necessary to kill him. Birds — at least 
pigeons — I have found will often recover after the 
hypodermic injection of two grains of atropine, and 
three grains by the mouth did not prove fatal. A very 
curious and at present inexplicable fact, which I have 
repeatedly verified, is that the pupils in pigeons can- 
not be dilated by the use of belladonna."* Dr. C. 
D. F. Phillipsf cites authority for the statement that 
goats eat belladonna leaves with impunity. Not 
only do the dynamic effects of a drug in human be- 
ings frequently differ from those in one of the lower 
animals, but the dynamic effects of a drug in one of 
the lower animals may be very different from those 
in another animal of a different class, order, genus 
or even species. Ipecacuanha is an emetic to men 
and to dogs, but not to rabbits; the same is true of 
tartarized antimony. It is probable that caffeine 
will produce rigor mortis markedly in frogs of one 
species — little, if at all, in those of another species. J 
Never confound drug pathogenesy with materia med- 
ica pura: by the former we mean unmodified dy- 

*H. C.Woods "Therapeutics: Its Principles and Prac- 
tice," eighth edition, pp. 207-8. 

f " Materia Medica and Therapeutics," p. 531. 
X See Brunton, pp. 54, 56. 



HOMOEOPATHY THE ONLY SYSTEM. 33 

namic effects producible by drugs in animals includ- 
ing man; by the latter we mean unmodified dynamic 
drug effects in man. 

From the foregoing you will see that, while we 
may look to experiments with drugs upon the lower 
animals for assistance in developing our knowledge 
of materia medica pura, these experiments can never 
take the place of drug-proving upon human beings, 
— any more than can facts regarding drugs as stud- 
ied by the chemist, the crystallographer and the 
physicist, various of which facts may aid us in de- 
veloping a knowledge of materia medica pura.* 

Just here seems the best point at which to speak 
of certain non-homceopathic, non-curative uses, not 
yet mentioned, of drugs, which uses are based upon 
our knowledge of materia medica pura. A patho- 
genetic effect upon man of atropine is to dilate the 
pupil. Give atropine to a well man by the mouth, 
or hypodermically, or locally by dropping it into 
his eye, and you will find that an unmodified dynamic 
effect of the poison is dilatation of the pupil, i. e. x 
the drug is a mydriatic. Now when the iris is in- 
flamed, or the lens of the eye is inflamed, there is 
danger that as a result of plastic exudation there will 



* See T. Lauder Brunton's "Introduction to Modern 
Therapeutics." 
3 



34 PRINCIPLES OF MEDICINE. 

occur an adhesion of the iris to the lens which will 
be a permanent lesion very undesirable. When such 
inflammation exists, drop a solution of atropine sul- 
phate into the eye, and, the pupil dilating, the free 
border of the iris is removed from contact with the 
lens. Keep up this mydriasis until the inflammatory 
process has spent itself, and you will have forestalled 
the dreaded adhesion. This certainly is not homoe- 
opathic; equally certainly it is not curative; to in 
any way modify the inflammatory process is not 
the direct object of such treatment. The object 
of such treatment is simply prophylactic — to, as 
I say, forestall the undesirable adhesion. This is 
an illustration of useful non-curative treatment, 
based upon our knowledge of a fact in materia 
medica pura. 

Again: give enough opium or morphine to a 
man in health, and a dynamic effect of the poison 
will be that he will become benumbed and sleepy; 
if still more be given, he may fall into a coma. 
When a patient is suffering from extreme pain, you 
frequently can with opium or morphine benumb 
him, so that he will become insensible to the pain 
until the abnormality of the vital processes has spent 
itself. This is not homoeopathic and not curative 
treatment; cautiously practiced, it may be useful. 



HOMCEOPATHY THE ONLY SYSTEM. 35 

In chronic cases such treatment has not infrequently 
proved disastrous. 

If now, from what I have said, or from previous 
study of the subject, you have come to feel confi- 
dence in sitnilia as the only possible law of cure, you 
can appreciate the wisdom of that reply which was 
once made to the question, "What remedy shall I 
give to this patient?" The reply was, "Give the 
remedy indicated." In no two cases are disease 
effects precisely the same, and each patient should 
be treated, if we would cure him, with the remedy 
indicated by the disease effects manifest in him. If 
B is cured of syphilis by the use of mercury, it is 
not because A was cured of syphilis by the use of 
that drug: each is cured, because mercury is capable 
of producing effects similar to those produced by 
syphilis in him. This illustration should, I think, 
make perfectly plain to you the fact that statistics 
regarding results in homoeopathic practice may 
afford evidence of the truth of simiiia, but should 
never constitute our reason for the choice of a rem- 
edy as homoeopathic in a case under treatment. 
The reason for this choice should always be that the 
medicine chosen is capable of producing in human 
beings unmodified dynamic effects similar to the 
disease effects manifested in our patient. The bear- 



36 PRINCIPLES OF MEDICINE. 

ing of this truth upon the introduction of proved, 
but hitherto unapplied remedies, is evident. I advise 
you to regard as suggestive, rather than as final, 
whatever I may say upon the therapeutic use, in 
homoeopathy, of individual drugs. 



III. 

WHAT SHALL WE PROVE ? 



[Reprint from the North American Journal of Homoeopathy for 
April, 1891.] 



III. 

WHAT SHALL WE PROVE? 



Reason is an ever-ready friend to the drug- 
prover, as, indeed, she is to one engaged in any 
reasonable undertaking whatever. She is ready with 
an answer to the question: What shall we prove ? 
and a part of her answer certainly is: Poisons. 

Now, it happens that some substances with which 
provers have experimented are not conspicuously 
poisons: among them are carbo vegetabilis, lyco- 
podium and natrum muriaticum. I tend toward the 
belief that no one of these three substances is really 
a pathogenetic agent; and, if that belief is correct, it 
follows (not as a matter of opinion, but as a matter 
of fact), that no one of them can possibly be homoeo- 
pathic in any circumstances whatever. The fact 
that cures have been accredited to these substances 
must not be admitted in evidence when the question 
(39) 



4-0 PRINCIPLES OF MEDICINE. 

is whether they are homoeopathic medicines; for 
pathology (including objective as well as subjective 
effects) and drug pathogenesy only (not therapy) are 
the fields in which can be determined a question of 
homoeopathicity. 

To pick up indiscriminately this, that or the 
other thing, and undertake a proving of it is to pro- 
ceed without method and with not the best chance of 
adding to our knowledge of materia medica pura. 
Reason says: Prove substances which unquestionably 
are dynamic poisons: by heeding her we shall greatly 
economize both time and labor. 



IV. 
HOMCEOPATHY versus EMPIRICISM. 



[Presented to the Minnesota Institute of Homoeopathy in Ma}-, 1891. 
Reprinted from North American Journal of Homoeopathy for July, 1891.] 



IV. 
HOMOEOPATHY versus EMPIRICISM. 



The point of which I would speak is so very 
simple, and has been so urged by Hahnemann 
(though perhaps not always consistently), and by 
various of his followers, that some of my hearers will 
feel that enough has been said of it, and that there 
is no occasion for again bringing it to the front and 
making it the subject of even a very short paper. 
To me it seems that there still is occasion for urging 
this point, and will be until there is, by all physicians, 
a practical recognition of it. The point concisely 
stated, is: In practicing homoeopathy, give the remedy 
indicated. 

We all know that some of our records of a drug's 

pathogenesy have been more or less vitiated by the 

introduction, as drug-effects, of symptoms which are 

not effects induced by the drug taken in health, but 

(43) 



44 PRINCIPLES OF MEDICINE. 

are disease-effects from which a patient has recovered 
while under treatment with the drug. So far as in 
prescribing one is led by such a symptom, his 
practice is purely empirical. I have no objection to 
an empirical practice, when it seems the most promis- 
ing for good to a patient; but I most cordially join 
with those who are protesting against the vitiation of 
our records of materia medica pura in the way just 
cited. These records should be kept pure, and no 
symptom should be admitted into them on any 
ground other than that it has been observed as a 
pathogenetic effect. If results of practice are to be 
admitted (unspecified) into the same records with the 
results of scientific investigation in the field of drug 
pathogenesy, it is merely a question of time when in 
these records the facts of science and the notions of 
empiricists will constitute a conglomeration from 
which it will be impossible to obtain any accurate 
scientific knowledge; and without accurate scientific 
knowledge of drug pathogenesy it is impossible to 
practice homoeopathy scientifically, i. <?., with the 
(or an) indicated remedy. 

The practice of homoeopathy is an art, and the 
perfecting of it must be preceded by a perfecting of 
the sciences on which it is based. One of these 
sciences is drug pathogenesy, and this science we 



HOMOEOPATHY VS. EMPIRICISM. 45 

should develop in a purely scientific spirit, as eager 
to discover errors as to discover truths in its records. 
We should by no means distort or wrench in any 
particular the facts of pathogenesy, trying to make 
them harmonize with what an empirical practice 
might lead us to suppose would be pathogenetic 
effects of a drug. 

Our practice is empirical so far as it is based upon 
characteristics or keynotes which have arisen from 
experience in therapy only. A prescription based 
only on such characteristics or key-notes is purely 
empirical; a prescription may be more or less 
homoeopathic but have an empirical tinge because 
determined in part by regard for such indications. 



V. 

EMPIRICISM— RATIONAL PRACTICE 

—PRACTICE UNDER GUIDANCE 

OF LAW. 



[A Lecture to Medical Students. Reprinted from the North American 
Journal of Homoeopathy for January, 1892.] 



V. 



EMPIRICISM — RATIONAL PRACTICE- 
PRACTICE UNDER GUIDANCE 
OF LAW. 



Any given practice with a drug we may, with 
regard to the dominant character of that practice, 
classify under one or another of three headings, 
viz. : Empiricism, rational practice, practice under 
guidance of law. I say, with rega?'d to the dominant 
character of the practice, for (and to this thought we 
shall recur) a given practice may be not wholly em- 
pirical, not wholly rational, not wholly under guid- 
ance of law. I wish to lay before you these three 
methods of practice, in each of which you will, I 
believe, find more or less that is good. 

Empiricism. — For present purposes I define em- 
piricism as the practice in which one gives a partic- 
ular drug for the sole reason that he believes it (or a 
4 ' (49) 



50 PRINCIPLES OF MEDICINE. 

drug more or less similar to it) to have done good 
in previous cases (or a case) more or less 
similar to a present one. Please observe that empir- 
icism thus defined does not include the hap-hazard 
giving of drugs without a posteriori reason. To 
assert that no good had ever come from hap-hazard 
practice in the past would, perhaps, be incorrect. 
For aught I know the initial practice with any given 
drug among savage people is hap-hazard, and we all 
know that some valued practices with drugs are sim- 
ply in imitation of practices with them among savage 
people.j But I would urge that in civilized lands 
medical science and medical art have at this day 
reached a stage of development at which we may 
well dispense with hap-hazard practice. Consider, 
for a moment, that for any given hap-hazard prac- 
tice there is no particular reason either a priori or 
a posteriori; and you cannot, I think, fail to agree 
with me that the medical world today should not 
resort to hap-hazard empiricism. In hap-hazard 
practice any one substance, whether poisonous or 
inert and whatever its peculiar properties, would be 
as eligible as any other substance, whatever the dis- 
ease affecting a given patient, and whatever the con- 

i It might, by the way, be queried whether, in an initial 
practice, the savage is not guided by some faculty analogous 
to instinct. 



EMPIRICISM RATIONAL PRACTICE. 5 I 

dition in which that patient might be. 2 Hap-hazard 
empiricism discontinued, new material as a basis for 
legitimate empiricism would arise not only from 
legitimate empiricism itself, but also from our 
attempts at rational practice, and at practice under 
guidance of law; for in these attempts we are liable 
to meet with various practices which we shall con- 
tinue for the a posteriori reason that they seem useful, 
after it shall have become evident that we were mis- 
taken in regard to some of the data by which we 
were in the first instance led to adopt them — which 
data being found incorrect, we can no longer con- 
tinue the practices as rational or as under guidance 
of law. 

The empiricism which we shall consider (and 
shall at times call legitimate as distinguished from 
hap-hazard empiricism) is, then, that practice in 
which we give a particular drug for the sole reason 
that we believe it (or a drug more or less similar to 
it) to have done good in previous cases or a previous 
case more or less similar to a present one. Before 
leaving the subject of empiricism I shall assign rea- 
sons for believing that the time will never come 

2 I am not sure that Brunton would entirely discard hap- 
hazard empiricism. See p. 3 of his "Pharmacology, Thera- 
peutics and Materia Medica," adapted to the United States 
Pharmacopoeia by Francis H. Williams, M. D., third edition. 



52 PRINCIPLES OF MEDICINE. 

when the best physicians will entirely discard em- 
pirical practice, but I wish first to impress upon 
your minds the fact that empiricism is essentially 
feeble. Its inherent feebleness is due to the fact 
that empiricism utterly ignores any proper distinc- 
tion between the science of drugs 3 and the art (which 
is therapeutics) of using them. That you may clearly 
understand what this distinction is, I quote an aph- 
orism from WhewelPs Novum Organon Renovatum.^ 
"Art and Science differ. The object of Science is 
Knowledge; the objects of Art are Works. In Art, 
truth is a means to an end; in Science, it is the only 
end. Hence the Practical Arts are not to be classed 
among the Sciences." The same thought which 
Whewell thus expresses has been more concisely 
expressed as follows: "In science, scimus ut sciamus; 
in art, scimus ut producamus."^ 

Let us for a moment consider some details 
presented by a slight expansion of the theme that 
empiricism is essentially weak in that it ignores any 

3 Some substances are medicine by reason of physical 
properties — some,' by reason of chemical properties — some, by 
reason of dynamic properties. The pure science of drugs in- 
cludes, therefore, facts of physics, facts of chemistry, and 
facts of pathogenesy. Materia medica pura is only that part 
of the pure science of drugs which deals with their unmodified 
or pure effects as pathogenetic dynamic agents in man. 

4 Third edition, p. 129. 

5 Karslake, as quoted under Science in Webster's Dictionary. 



EMPIRICISM RATIONAL PRACTICE. 53 

proper distinction between the science of drugs and 
the art of therapy. 

1 st. While it is perfectly legitimate in the prac- 
tice of medicine to incidentally make observations 
for the advancement of medical science, it is never 
legitimate to make the advancement of science the 
main object of medical practice. That main object 
should always be to benefit the patient. The main 
objects of medical practice are (to use Whewell's 
word) Works. 6 Empiricism, in that it is based solely 
upon experience in previous practice, has in its 
foundation no pure science of drugs, the only imme- 
diate object of which is knowledge. 

2nd. Ignoring the science of drugs, legitimate 
empiricism uses as foundation material drug facts 
which have already appeared in its superstructure. 
The drug facts in its foundation to-day were in its 
superstructure yesterday, and the drug facts in its 
superstructure to-day will be in its foundation to- 
morrow. In the foundation of legitimate empiricism 
there is pure science of disease, though none of 
drugs. 7 

6 "The physician's highest and only calling is to restore 
health to the sick, which is called Healing." Opening words 
of Hahnemann's Organon: Dr. C. Wesselhoeft's translation. 

7 Though it is characteristic of empiricism to ignore any 
pure science of di'ugs in a foundation for practice, it is not 
true that empiricism ignores the pure science of disease. In 



54 PRINCIPLES OF MEDICINE. 

3d. While empiricism does not look to pure 
science of drugs for materials to use in constructing 
a foundation upon which afterwards to erect, as a 
superstructure, the art of medical practice, she 
may, and to some extent does, look to pure science 
of drugs for materials which she would thrust in as 
underpinning for a superstructure which she has ap- 
proved. Conspicuous examples of her having done 
this are to be found in the history of mercury and 
quinine as medicines. For at least several hundred 
years either of these has been empirically used — the 
one being given to syphilitic patients and the other 
to malarial patients; and to this day empiricism, be- 
lieving (correctly, I think,) that these drugs are 
useful to many of these patients, is asking the pure 
science of drugs why they are useful. 

4th. Theory and practice is a phrase common in 
the medical world. Empiricism seems to have 
(properly speaking) no theory. In defining theory 
Webster says: " The science distinguished from the 
art; as, the theory and practice of medicine." Em- 
piricism has no science of drugs distinguished from 

hap-hazard empiricism the science of disease (beyond the 
recognition of disease in general as distinguished from health) 
might be ignored; but to legitimate empiricism something of 
the pure science of disease is essential, for legitimate empiri- 
cism involves a recognition of similarity between two or more 
disease conditions. 



EMPIRICISM RATIONAL PRACTICE. 55 

the art of using them: it is all practice and no theory; 
or, for a given empirical practice some theory 
may be offered, but only such as has been con- 
structed after the practice has been accepted. Cart 
before horse. 

Having shown you that empiricism is essentially 
feeble, and why it is so, I now ask you not to hastily 
conclude that you will make no use of empirical 
practice. We shall presently see that progress in 
sciences must precede progress either in rational 
practice, or in practice under guidance of law. Now, 
as our knowledge of a science can never be complete, 
there always may arise cases in which we have not the 
data necessary to a rational practice or to practice 
under law, and in which empiricism is our only 
resort; or else cases in which our practice, though 
in the main rational or under law, is more or less 
modified by considerations which give it a tinge of 
empiricism. In a given case, though we have the 
data for a rational practice or for practice under 
law, we may choose to follow empiricism as promis- 
ing better results than either of them. We may 
hope that, as our knowledge of medical science 
increases, empiricism receding will more and more 
give place to rational practice, and to practice under 
guidance of law. 



56 PRINCIPLES OF MEDICINE. 

Rational Practice. 8 — For present purposes I 
define rational practice as that practice in which 
one selects and uses a particular drug, for the reason 
that — in view of certain disease effects present, or 
proximate causes of those effects (which effects or 
causes he knows as scientific fact) and of certain 
physical, chemical, or pathogenetic properties of 
that drug (which properties he knows as scientific 
fact) — he deduces from an a priori premise that the 
patient will be benefited by having produced in him 
one or more of the pathogenetic effects of the drug, 
or by having produced in his tissues, secretions or 
excretions one or more effects of the drug as a physi- 
cal or chemical agent; or by having the drug brought 
to act as a physical, chemical or dynamic agent upon 
some proximate cause of disease. 9 

8 It seems hardly necessary to explain that a technical use 
of the term rational practice, does not do away with the ordi- 
nary meaning of rational. I have given reasons for believing 
that it is rational to, on occasion, resort to empiricism, and 
I think it is pre-eminently rational to practice homoeopathy, 
but neither empiricism nor homoeopathy is, technically, 
rational practice as here denned. 

9 As I said at the beginning of this lecture, and shall again 
say at its close, a given practice may be not wholly rational or 
wholly empirical. Experience in practice may afford an a 
posteriori basis for a practice originally based upon an a 
priori reason — for, for instance, various practices with 
anaesthetics, anodynes or mydriatics. In my definition the a 
priori element is recognized as a characteristic of rational 
practice. The major premise is more or less general, and we 
would by deduction arrive at a particular application of it. 



EMPIRICISM— -RATIONAL PRACTICE. 57 

In passing I remark that in rational practice it is 
never amiss to be on one's guard against producing, 
besides the intended drug effect or effects, other and 
harmful drug effects. 

Let us now consider some of the particular 
features of rational practice, and contrast them with 
features of empiricism. 

1st. For one feature and contrast see footnote 9. 

2d. Rational practice presupposes a knowledge 
of pure science both of disease and of drugs. 
Legitimate empiricism ignores the pure science of 
drugs. 

3d. Any given rational practice necessarily in- 
volves a definite conception of the immediate end 
sought in the practice. In empirical practice regard 
is had only to results in previous practice, which 
results may be remote effects of the medicine. In 
rational practice one cannot aim at a remote end ex- 
cepting through an immediate end at which he 
definitely aims. 

4th. Rational practice is vastly more worthy 

of cultivation than is empiricism. The essential 

superiority of rational practice over empiricism is, I 

take it, largely due to the fact that rational practice 

Contrast this with the fact that to any given empirical practice 
the reason is a 'posteriori and the reasoning process inductive. 



5# PRINCIPLES OF MEDICINE. 

(as a whole) has the benefit of man's faculty of 
imagination and faculty for logical deduction (each 
of which faculties is, perhaps, one of the marks 
distinguishing man from brute), while empiricism 
has not that benent 10 . The exercise of these facul- 
ties benefits rational practice as a whole, but not 
every particular rational practice. To a particular 
rational practice the imagination may be engaged 
with true ideas or with false, and the deduction may 
be logical or illogical. A particular rational practice 
based upon a logical deduction from a premise in 
itself true may fail of effecting the ultimate end pro- 
posed, by reason of some circumstances which the 
premise did not take into account. A particular 
rational practice not only may fail of effecting the 

10 ' 'Lastly, physical Investigation more than anything 
besides helps to teach us the actual value and right use of 
the imagination — of that vuondrous faculty, zvhich, left to 
ramble uncontrolled, leads us astray into a zvildemess of 
perplexities and errors, a land of mists and shadozvs; but 
zvhich properly controlled by experience and reflection, be- 
comes the 7ioblest attribute of man: the source of poetic 
genius, the instrument of discovery in Science, zvithout the 
aid of zvhich Nezvton zvould never have invented fluxions, 
nor Davy have decomposed the earths and alkalies, nor 
zvould Columbus have found another continent." Address 
to the Royal Society by its President, Sir Benjamin Brodie, 
November 30, 1859, as quoted by Tyndall in a discourse be- 
fore the British Association, On the Scientific Use of the 
Imagination . 

"If experience is not directed by theory, it is blind."" 
Bacon as quoted by Headland On the Action of Medicines^ 
ninth American edition, p. 18. 



EMPIRICISM RATIONAL PRACTICE. 59 

ultimate end proposed, but may do harm — even great 
harm: it may even prove fatal. It is exceedingly 
important to remember this in those instances where 
a particular rational practice has as its immediate 
end the production in the patient of pathogenetic 
(sometimes called physiological) effects of a drug. lt 
While, then, I speak of rational practice as very de- 
cidedly worthy of cultivation, I add that one should 
never cultivate rational practice excepting with 
caution. Caution is agreeable to the theory of 
rational practice, and in the history of rational 
practice there is ample record of such havoc as one 
may make if he is not cautious. 

While speaking of empiricism I said that in 
particular cases we may be without the scientific 
data necessary to a rational practice. The limita- 
tion to which rational practice is in a particular 
instance subjected by such insufficiency of scientific 
data may be incidental and temporary. I shall wish 
your particular attention to one limitation inherent 
in rational practice, but of this I can speak better 
when we shall have noted a definition of the end 
sought in any given practice of homoeopathy. 

11 Calling pathogenetic effects physiological effects seems 
to suggest and foster a false notion. The processes of which 
physiology, as distinguished from pathology, is the science are 
normal; pathogenetic effects are not normal. See footnote on 
p. 94 of this book. 



60 PRINCIPLES OF MEDICINE. 

Practice Under Guidance of Law. — A law of 
nature is a general principle to which there is no ex- 
ception whatever. Regarded from the standpoint of 
inductive science, a law of nature is an ultimate fact. 
Inductive science simply recognizes, or else fails to rec- 
ognize, a given law as a fact; noting a given law it does 
not attempt to explain why that law is such as it is. 

It has been inferred as a general law "that acids, 
applied topically, check the production of acid 
secretions from glands, while they increase the flow 
of alkaline secretions; the very reverse being the case 
with alkalies, for alkalies applied to the orifices of 
glands with acid secretions increase their secreting 
power; while alkalies applied in a corresponding 
way to glands with alkaline secretions lessen or check 
this secretion. " 12 If this is a law, it is one by which, 
it seems, we could be guided in only an exceedingly 
small proportion of the instances in which medical 
aid is sought. Furthermore, it does not appear that 
this purports to be a law of therapeutics as distin- 
guished from hygiene. 

Whatever laws of therapeutics there may be, I 
shall in a subsequent lecture 13 present to you some 

12 Handbook of Therapeutics, by Sydney Ringer, M. D., 
eleventh edition, p. 158. 

13 See in this book two lectures upon Homoeopathy the 
only System of Curative Medicine. 



EMPIRICISM RATIONAL PRACTICE. 6 I 

of my reasons for believing that similia similibus 
curantur is the only possible law of that cure which 
I define as such modification of the quality of vital 
processes and their effects that, whereas these pro- 
cesses and effects are abnormal they shall become 
normal (or approximately so), and that as the im- 
mediate (not remote) result of the medicine used. 

This is the place at which I shall point out one 
limitation inherent in rational practice. Rational 
practice is not competent to attempt the cure which 
I have just defined, for an essential to that cure is a 
definite modification of vital processes, and these 
processes per se are unknowable to inductive science. 
Aside from proximate causes, these processes are 
knowable to such science only in effects, and a datum 
necessary to such cure is a law of nature stating the 
relation between disease effects and the pathogenetic 
dynamic effects of a curative drug. This matter we 
shall discuss in detail in a subsequent lecture. 13 

If you will study the definition I have given of 
that cure at which the practice of homoeopathy 
aims, you may, I think, conclude that, in itself con- 
sidered, this is the best cure conceivable as an 
object of practice with drugs. 14 You may care to 

14 What is here spoken of as, in itself cojisidered, the best 
cure conceivable, is identical with what in the two lectures 
upon Homoeopathy the only System of Curative Medicine is 



62 PRINCIPLES OF MEDICINE. 

sometimes bring that conclusion to bear upon a 
question often raised, viz. : Why is it that physi- 
cians who do not practice homoeopathy only, but 
gladly adopt rational practices and on occasion 
resort to empiricism, nevertheless identify them- 
selves by name with the particular principle upon 
which the practice of homoeopathy is based ? 

As similia is the only definitely stated principle 
which I accept as a law of therapeutics as distin- 
guished from hygiene, I shall devote my further re- 
marks under the present heading to some features 
of practice under guidance of similia, comparing 
them with features of empiricism and with features 
of rational practice. 

ist. The practice of homoeopathy presupposes a 

knowledge of the pure science of disease as known 

in effects; rational practice as a whole presupposes 

recognized as the only cure possible. It seems to simplify 
matters to call this alone cure as distinguished from results of 
hygienic measures and of prophylaxis, and from various kinds 
of palliation. Accepting the broadest definition of cure, it is 
curative to secure quiet for your patient by scattering tan-bark 
on the cobble-stones in the street, or by stopping his neigh- 
bor's boy from playing on a drum — it is curative to bathe his 
forehead, smooth his pillow or direct his diet — it may be cura- 
tive to benumb him with morphine, or to kill germs. Under 
the broadest definition of cure, any measure useful to your 
patient as a patient is curative. To me it seems obvious that 
the most intelligent consideration of homoeopathy's claim is 
possible, only when the cure at which the practice of homoe- 
opathy aims is accurately denned. 



EMPIRICISM RATIONAL PRACTICE. 63 

knowledge of a part of this science, and also a 
knowledge of proximate causes of disease. The 
practice of homoeopathy presupposes a knowledge 
of the pure science of drugs only as pathogenetic 
agents in man, i. e., a knowledge of materia medica 
pura; rational practice as a whole presupposes a 
part of the pure science of drugs as pathogenetic 
agents in man, and also the pure science of drugs as 
medicines by reason of physical or chemical prop- 
erties, and as dynamic poisons to germs, etc. Legit- 
imate empiricism ignores the pure science of drugs, 
but not of disease. Let us for a moment dwell upon 
and illustrate these two facts: first, in theory homoe- 
opathy could use all the science of disease as known 
in effects, but rational practice could use only a part 
of that science; — second, in theory homoeopathy 
could use all of materia medica pura, but rational 
practice could use only a part of materia medica 
pura. 

It seems probable that in the science of disease 
as known in effects there are indefinitely many facts, 
a knowledge of which could be used in the practice 
of homoeopathy, but not in rational practice. For 
instance, various facts regarding pain (as the part 
to which it is referred, the character of the pain, cir- 
cumstances which aggravate and those which relieve) 



64 PRINCIPLES OF MEDICINE. 

may be significant to one practicing homoeopathy, 
but insignificant to one who is administering mor- 
phine as an anodyne. It seems probable, too, that 
indefinitely many facts of materia medica pura avail- 
able in the practice of homoeopathy are not available 
in rational practice. What use can rational practice 
make of the fact, according to Moreau as quoted by 
Stille 15 that a " 'very common feeling,'" caused by 
cannabis, " c is that of the brain boiling over and 
lifting the cranial arch like the lid of a teakettle ' " ? 
Rational practice can theorize as to whether this 
drug symptom is due to cerebral congestion or to 
cerebral anaemia or to some other condition, and 
can then base a prescription of the drug upon the 
theory adopted, whatever that maybe; but to rational 
practice the peculiarity of the sensation as here 
described by Moreau, without theory, is insignifi- 
cant. Stille 16 cites authority for the statement that 
as an effect of cannabis the whole body was the seat 
of sensations compared with those produced by slight 
electric sparks, and "an acrid heat was felt wher- 
ever the skin was pressed." These symptoms, with- 
out theory as to their cause, may be utilized in 
prescribing cannabis as homoeopathic, but not in 

15 Stille's Therapeutics and Materia Medica, Fourth 
Edition, Vol. 1, p. 960. 
16 Ibid, 961. 



EMPIRICISM RATIONAL PRACTICE. 65 

rational practice with the drug/ I do not urge that 
these observations cited by Stille are correct; I 
adduce them only to illustrate that there may be 
facts of materia medica pura which in practicing 
homoeopathy we can utilize without theory as to how 
they are produced, but which we cannot so utilize in 
rational practice. Again, it seems probable that 
many facts of materia medica pura, available in the 
practice of homoeopathy, are because of their vio- 
lence (if for no other reason) not available in 
rational practice excepting as warnings not to give 
too much of a particular poison: inflammation of the 
kidneys with albumen and casts in the urine — also 
fatty degeneration of various viscera are, perhaps, 
among such drug effects. In the theory of homoe- 
opathy no objective or subjective effect of a drug as 
a dynamic pathogetietic agent in man is without value 
as among data by which the drug may be indicated 
as curative. I believe that the science of materia 
medica pura is inexhaustible — that thus far the work 
in its field has been barely begun — and that very, 
very much that purports to be record of drug patho- 
genesy is erroneous. 

2d. In the practice of homoeopathy, that simi- 
lars cure is a general premise from which we would 
deduce what particular drug (or drugs) will cure in 



66 PRINCIPLES OF MEDICINE. 

a particular instance. 17 In rational practice, too, 
the reasoning process in any given case is deductive; 
but in rational practice the general premise may be 
true or false, while in practice under guidance of 
similia it is, I believe, a law of nature. In any 
given empirical practice the reasoning process is in- 
ductive. 

3d. Any given practice under guidance of similia 
should, I think, involve a definite conception of the 
immediate end sought in the practice. So, too, as 
we have seen, to any given rational practice is-neces- 
sary a definite conception of the immediate end 
sought; while in empirical practice the end sought 
may be remote and the conception of that end vague. 

I presume that some men have practiced under 

guidance of similia without a definite conception of 

the immediate end sought — perhaps with so vague a 

conception of an end, either immediate or remote, 

as is expressed in the words the betterment of the 

patienfs condition. A perfectly fair question from a 

physician who is not a homoeopathist to a homoeopa- 

17 I say drug (or drugs) . Given the effects by which, in 
a particular case, disease is known: by some of those effects 
one drug may be indicated as homoeopathic; by other of those 
effects, another drug. By the same disease effects different 
drugs may be indicated as in different degrees homoeopathic, 
in which case (unless because of some empirical consideration) 
the more homoeopathic drug is to be preferred to the less 
homoeopathic. 



EMPIRICISM RATIONAL PRACTICE. 6j 

thist who gladly adopts some rational practices, 
and who on occasion resorts to empiricism is: If 
similia is law, why do you practice anything else 
than homoeopathy? Assuming that the inquirer 
really wants to know something about homoeopathy, 
and that it really seems to him inconsistent that the 
homoeopathist should practice anything else than 
homoeopathy, you may, I think, do him an immense 
service by, among other things, showing him what 
cure similia is the law of, and that it is the law of 
nothing else — by showing him in what respect the 
immediate end sought in the practice of homoeopathy 
differs from the immediate end sought in any given 
rational practice. I think that an understanding 
upon this point might immensely facilitate the estab- 
lishment of more useful relations between physicians 
who are homoeopathists and physicians who are not 
homoeopathists. 

At the beginning of this lecture I said we should 
recur to the thought that a given practice may be 
not wholly empirical, not wholly rational, not wholly 
under guidance of law. Your choice of a particular 
drug may be primarily based upon a principle of 
rational practice, or upon similia, and that choice 
may be empirically confirmed by a consideration 
solely of past experience in practice; or your choice 



68 PRINCIPLES OF MEDICINE. 

of a particular drug may be primarily empirical, and 
that choice confirmed by considerations which seem 
to afford for the use of the drug in the circumstances 
a basis in rational practice, or by considerations 
which seem to show that the drug is more or less 
homoeopathic to disease as manifested in your 
patient. 

Though we may hope to some day discover a law 
or laws of dosage, no such law is at present known; 
wherefore, in respect to dosage, no practice is at 
present under guidance of law. Empirical and 
rational considerations may both be brought to bear 
upon questions of dosage. 

Let me, before closing this lecture, impress upon 
you the importance of remembering, in dealing with 
materia medica pura, that it is a science. I have no 
doubt that a vast deal of error in our records of 
materia medica pura is due to the fact that when a 
patient under treatment with a given drug has recov- 
ered from a given symptom, some reporter has 
assumed that a similar to that symptom could be 
produced by that drug: thus have arisen what are 
called "clinical symptoms. " Or recovery from a 
symptom similar to one attributed in pathogenesy to 
the drug which the patient is taking, has been re- 
garded as evidence that the record of pathogenesy is 



EMPIRICISM RATIONAL PRACTICE. 69 

correct. Such "clinical symptoms" and "clinical 
verifications" are legitimate as empirical indications, 
but have been fruitful sources of error in our records 
of materia medica pura. Never attempt to wrench 
the facts of science into conformity with precon- 
ceived notions. Materia medica pura is a science, 
and as such should be developed in a purely scien- 
tific spirit without any immediate regard whatever to 
the therapeutic use of facts in that science. 



7o 



PRINCIPLES OF MEDICINE. 



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EMPIRICISM RATIONAL PRACTICE. 7 I 

18 The dotted lines connect that part of drug science with 
the method of practice in the foundation of which it is. Ob- 
serve that no dotted line connects the science of drugs with the 
art of legitimate empiricism. 19 Some of these agents are per- 
haps not, properly speaking, medicines. 20 These old-time 
practices may serve as illustrations, though I am not aware 
that any physician to-day would adopt either of them. They 
were rational practices, but have been discarded, as has many 
another rational practice. The trouble with the mercury 
practice was that it was more apt to do incidental harm than to 
effect the intended good; and the trouble with the mucuna 
practice, that the drug spiculae, when moistened in the in- 
testine, no longer possessed those physical properties for the 
sake of which mucuna was given. 21 Perhaps it would be 
premature to conclude that no useful practice is possible with 
neutralizers (chemically) of ptomaines. 22 The benumbing 
effect of morphine and the mydriatic effect of atropine are, for 
instance, facts of materia medica pura which rational practice 
can utilize. Drug effects similar to disease effects supposed 
at bottom of p. 63 could not be utilized in rational practice. 
As to facts of materia medica pura which cannot (without 
theory as to their production) be utilized in rational practice, 
see pp. 64, 65 of this book. 23 As to facts of disease science 
which would be insignificant in selection of a drug in rational 
practice see pp. 62 to 64. 24 Pages 24 to 27 of this book to- 
gether with note on pp. 28, 29 offer reasons for disbelief in any 
law of contraries. I see no reason for thinking that there is, 
other than similia, any law of therapeutics as distinguished 
from hygiene. Of course there may be some undiscovered 
laws of therapeutics, but in my chart I let homoepathy appear 
as synonymous with practice under guidance of law. 

Homoeopathy is not a part of rational practice. The im- 
mediate object of a ratiojial practice with a drug as known in 
materia medica pura is to produce in the patient a definite 
pathogenetic effect; the immediate object in any given practice 
of homoeopathy is to so modify the quality of vital processes 
and their effects, that, whereas these processes and effects are 
abnormal, they shall become normal (or approximately so), 
and that as the immediate result of the medicine used. 



VI. 

HOW TO STUDY AND HOW TO 
TEACH MATERIA MEDICA. 



[Paper presented at the American Institute of Homoeopathy in 18 
Reprinted from the North American Journal of Homoeopathy.] 



VI. 



HOW TO STUDY AND HOW TO TEACH 
MATERIA MEDICA.* 

i. What advice do you give concer?iing Materia 
Medica to a student beginning medicine by a year's 
preliminary study? 

It seems to me of the utmost importance that at 
the very beginning of his course a medical student be 
made acquainted with the principles of medicine — 
all the principles upon which beneficial practice is 
based. When the field of medical practice is once 
clearly mapped out in his mind, the student of 
materia medica and therapeutics is prepared to in- 
telligently accept all that is good in any system of 
medicine, and to see that there is no conflict between 
homoeopathy and anything else that is good in 
medicine; he is prepared to show that a man can 

* The questions were proposed by Chairman of Materia 
Medica Bureau of American Institute of Homoeopathy. 

(75) 



76 PRINCIPLES OF MEDICINE. 

consistently be enthusiastic as a homoeopathist, and 
equally enthusiastic in his support of whatever be- 
side homoeopathy is good in medicine. 

I should advise a student beginning medicine by 
a year's preliminary study to (either before or 
simultaneously with his first studies in materia 
medica) acquaint himself with the various principles 
upon which the practice of medicine is based. I 
should show him just what empiricism is — wherein 
lies its essential feebleness; and should then give him 
reason for believing that the medical world will 
never entirely outgrow empiricism. I should show 
him just what rational practice is — just wherein lies 
its strength, and wherein its weakness, and that it 
can never intelligently attempt the cure attempted by 
homoeopathy. I should then show him what the 
principle of homoeopathy is — should define the cure 
it undertakes, should show that that cure is in a sense 
the highest cure which it is possible to undertake 
with drugs, and that it can never be intelligently 
undertaken in rational practice or in any other way 
than under the guidance of similia similibus curantur 
as a law of nature. The argument which I presented 
in favor of homoeopathy would be in the main an ab- 
stract argument by exclusion, but it would not be en- 
tirely such. I should cite some practices more or less 



HOW TO STUDY MATERIA MEDICA. 77 

approved which seem to me often homoeopathic (as, 
for instance, that of giving mercury to syphilitics, 
ipecac to those who are nauseated and vomiting, or 
jaborandi to relieve patients of sweating), and I 
might point to the history of homoeopathy en masse 
as part of the argument in its favor. In all my pre- 
sentation to this student I should scrupulously avoid 
anything like dogmatism. I should endeavor to 
present facts in such a way that he, without being 
urged, would seize upon correct conclusions. As 
for literature upon the principles of medicine, I 
should advise him to read Carroll Dunham's Science 
of Therapeutics, Dake's Therapeutic Methods and 
some things which I have written upon the subject. 

In the course of instruction above outlined, the 
student will have learned that materia medica is the 
whole science of drugs, and that materia medica pura 
is the science of drugs as dynamic pathogenetic 
agents in man. He will have learned that (while it 
is permissible that "clinical symptoms" and "clinical 
verifications" should give an empirical tinge to a 
prescription in general homoeopathic) similia is the 
only legitimate guide to a really homoeopathic remedy 
— he will have learned that only in the fields of 
pathology and drug pathogenesy can a question of 
homoeopathicity be determined. 



78 PRINCIPLES OF MEDICINE. 

We may hope that by this time our student shall 
have so intelligent a regard for pathogenesy that he 
will read most cautiously, and most critically, any- 
thing purporting to be a record of materia medica 
pura; we may hope that he will want to know patho- 
genesy, rather than what some one has written about 
pathogenesy. I should like a text book on materia 
medica pura schematically arranged, and with numer- 
ous references such that each item recorded might be 
traced to the original authority for that item. I am 
waiting with great interest to see whether in the forth- 
coming index to the Cyclopcedia of Drug Pathogenesy 
we are to have these schemata and these references. 
Allen's Encyclopcedia is schematically arranged, and 
has references: it is good as a book of reference for 
advanced students; its chief value is, I think, in 
showing the insufficient ground upon which are 
based many items in our text-books. I should not 
advise the beginner to make much use of this book, 
for I should want him to learn the grosser facts of 
drug pathogenesy before giving much attention to 
the minute points. I think the following named 
books (and their like) excellent for him who is 
beginning the study of drug pathogenesy: Taylor's 
Treatise on Poisons, the volume on Poisons in Whar- 
ton and Stille's Medical Jurisprudence, Reese's Med- 



HOW TO STUDY MATERIA MEDIC A. 79 

ical Jurisprudence and Toxicology. If, before setting 
this student at the study of pathogenesy at all, we 
have been successful in our attempt to instruct him 
in the principles of medical practice, we can serve 
him by now putting into his hands, not only text- 
books on materia medica by homoeopathists, but 
also the latest books on materia medica and thera- 
peutics by old-school writers, such as Brunton, 
Ringer, Bartholow, Stille, Phillips, George B. and 
H. C. Wood. With the previous instruction we have 
supposed, the student should have no difficulty in 
recognizing under what is in old-school books called 
"Physiological Action/'* very much that is not 
pathogenesy (as, for instance, what are perhaps ther- 
apeutic effects recorded with pathogenetic under the 
head of "Physiological Action"), and he will, at the 
same time, find in these books much useful informa- 
tion upon the subject of pathogenesy. Having had 
the training heretofore mentioned, he will not, to 
his dying day, forget that materia medica pura is a 
science, and is to be studied in a purely scientific 
spirit; he will never forget that any item in what is 
recorded as materia medica pura purports to be an 
item of drug pathogenesy, and that, if a question 
arises whether it is a fact of pathogenesy, the most 
* See p. 59 of this book, and footnote on pp. 94 and 95. 



80 PRINCIPLES OF MEDICINE. 

critical investigation of the question in the field of 
science (J. e., pathogenesy and never therapy) is al- 
ways in order. I quote, at second hand, from Tyn- 
dall what would be an excellent motto for all provers 
of drugs, and for all students of pathogenesy or of 
materia medica pura: " In every one of your experi- 
ments endeavor to feel the responsibility of a moral 

agent If you wish to become acquainted with 

the truth of Nature, you must from the first resolve 
to deal with her sincerely." 

2. Which is the best method of teaching Materia 
Medica {a) for the preceptor to his student — (<£) for 
the teacher to his classes in the college ? Give an 
outline of your method of studying or teaching a drug 
in the class-room. 

All that I have said regarding the importance of 
having a study of principles precede, or accompany 
from the first, a specific study of materia medica 
applies to work under a preceptor, and to class- 
room work, as well as to the work of such a student 
as was supposed in question No. i. In teaching 
materia medica, the preceptor may have scarcely 
more time to give to his pupil than will be required 
for directing his reading; but the teacher in the 
class-room may be expected to devote time neces- 
sary for personal inquiry into constantly arising 



HOW TO STUDY MATERIA MEDICA. 51 

questions. In teaching materia medica, no less than 
in teaching the principles of medicine, I should 
scrupulously avoid dogmatizing upon questionable 
points. The unquestionable facts of materia medica 
may be presented to the student with perfect confi- 
dence, but in materia medica (and in no department 
of it more conspicuously than in materia medica 
pura) there is, and always will be, very much regard- 
ing which there is question; a given question may 
sooner or later be answered, but new questions con- 
stantly arise. Dogmatism should have no place in 
answering questions of science. Discuss these ques- 
tions with your students, stating the pros and cons 
bearing upon each particular point, and try to lead 
the students to correct conclusions; but let them 
know that there are, and always will be, many ques- 
tions unanswered. Don't for an instant let the stu- 
dents suppose that you, or any one else, knows all 
of, for instance, materia medica pura, or that your 
opinion or that in a text-book is necessarily final. 
Teach with confidence the unquestionable facts, but 
always keep the questionable points distinct from 
the unquestionable. Hunt down items recorded as 
pathogenesy to the original sources upon which the 
record is based, and encourage your students to do 
the same. 

6 



82 PRINCIPLES OF MEDICINE. 

An outline oi my method of teaching a drug in 
the class-room: I first give what seems of interest 
regarding the origin and history of the drug, its 
botany or chemistry. When the drug is a serious 
poison I state the effects of serious poisoning by it, 
showing to the best of my ability (when there is 
occasion for so doing) what effects are due to its 
dynamic properties and what to its physical or 
chemical properties. I continue the study of its 
pathogenesy by taking up the old-school writers on 
materia medica, if the drug is one of which they 
treat. In using old-school writers I point out that 
much which they record under "physiological ac- 
tion/' is not pathogenesy, and I frequently point 
out what seems to me a fallacy underlying some one 
or other recommendation of theirs as to therapy. 
For (with few exceptions) each drug that I teach I 
have made out a chart of pathogenesy based upon 
toxicologies and old-school materia medicas and 
upon the Cyclopoedia of Drug Pathogenesy, going 
over each of these drugs in the Cyclopoedia, and 
crediting in my chart those items that come out 
repeatedly in the Cyclopoedia records. In these 
charts I give reference to authority for individual 
items. Of these charts I made (with a cyclostyle) 
enough copies to put a chart of each drug into the 



HOW TO STUDY MATERIA MEDICA. 8$ 

hands of each student. Intending the charts as 
records of pure pathogenesy I do not put into them 
"clinical symptoms" or "clinical verifications." I 
think that one who teaches "clinical symptoms" and 
"clinical verifications" should always keep them dis- 
tinct from records of pathogenesy. I give instruc- 
tion regarding such rational practices and such 
empirical practices as commend themselves to me. 

Xo drug can be a homoeopathic medicine uuless 
it is a dynamic poison. This is one of the reasons 
why I do not lecture upon some substances which 
are often lectured upon as homoeopathic medicines, 
e. g. natrum muriaticum and carbo vegetabilis. Re- 
garding some other substance (as lycopodium), I 
may say to the class: I hardly think that this is 
pathogenetic; and if not pathogenetic, it cannot be 
homoeopathic, — but many homoeopathists have re- 
garded it as having such and such a pathogenesy 
and as curative when given upon such and such 
indications. 

There is one set of substances upon whose 
records as pathogenetic I always look critically and, 
in the first instance, with suspicion. I speak of 
substances whose provings are alleged to show that 
practices accepted before those provings were made 
were homoeopathic. The history of practice with 



84 PRINCIPLES OF MEDICINE. 

these substances I try to bring out very clearly in 
the class-room. 

I encourage students to ask questions regarding 
pathogenesy and to discuss them with me in the 
class-room, so that for a part of the lecture-hour our 
exercises often become quite conversational. 

3. Which is the best place for teaching therapeu- 
tics— (1) hospital, (2) dispensary, (3) clinic, (4) class- 
room, or (5) bedside, and how should it be done? 

Both theoretical and practical teaching must 
have place. In each prescription purporting to be 
homoeopathic let the indications for the remedy be 
very definitely stated. Whenever a purely "clinical 
symptom" is made use of, let attention be called to 
the fact; also have attention called to any weight 
allowed "clinical verifications." Whenever a rational 
practice (as distinguished from homoeopathic) is 
adopted, let the theory for the prescription be 
clearly stated. Whenever a purely empirical pre- 
scription is made, the fact should be stated; so, too, 
when any empirical consideration modifies a pre- 
scription which in the main is rational or else homoe- 
opathic, the fact should be stated. 

4. Do you teach the potency of the remedy studied? 
If not, why not? If you do, how do you explain the 
potency you advocate? 



HOW TO STUDY MATERIA MEDICA. 85 

I do not teach potency. I advise students to go 
slow, if they tend to a belief in high potencies. 

5. When should the Organon be taught, and how? 

I do not use the Organon as a text-book. I 
think one can better teach homoeopathy without the 
Organon as a text-book than with it. 



VII. 

NEED OF DEFINITION OF THE END 
SOUGHT IN ANY GIVEN PRAC- 
TICE OF HOMOEOPATHY. 



[Reprinted from the North American Journal of Homoeopathy 
for October, 1895.] 



VII. 



NEED OF DEFINITION OF THE END 
SOUGHT IN ANY GIVEN PRACTICE OF 
HOMOEOPATHY.* 



A very great need in the medical world to-day is 
definition of the end sought in any given practice of 
homoeopathy. 

It is perfectly well known that a very large ma- 
jority of us homoeopathists do not repudiate prac- 
tices which we think useful though they are not 
instances of homoeopathy. It also is well known 
that this fact has been made the occasion for 
severely criticising us. Now this criticism may not 
disturb any one of us. A homoeopathist, feeling that 
he knows just what he is about, may ignore this 
criticism and give himself no concern about the 

* Presented at the 1895 meeting of the Homoeopathic 
Medical Society of the State of Michigan. 

(89) 



90 PRINCIPLES OF MEDICINE. 

critic. I think that often to ignore this criticism is 
to lose an opportunity for saying what might prove 
very useful. 

No homoeopathist need experience the least dif- 
ficulty in clearly and consistently answering this 
criticism. I believe that if each homoeopathist were 
in the habit of always so answering it, opposition to 
homoeopathy would in the future yield much less 
slowly than it has done in the past. I believe, too, 
that the most satisfactory answer to the criticism 
must include a definition of the cure at which any 
given practice of homoeopathy aims — must show 
something peculiar to that cure. 

I think it would be immensely serviceable to the 
medical world, if each homoeopathist would at his 
leisure compose or accept a concise, accurate defi- 
nition of the cure at which any given practice of 
homoeopathy aims — a definition with which he would 
always be ready and by which he could always stand 
in showing that an acceptance of homoeopathy is 
consistent with an acceptance of anything else that 
is good in medicine.* 



* See pp. 9, 16, 61 (including note), 66, 67 and 104 of this 
book. 



VIII. 

SOME CONSIDERATIONS BEARING 
UPON PRACTICE WITH DYNAMIC 
ANTAGONISTS IN CASES OF POI- 
SONING BY DYNAMIC DRUGS. 



[Reprinted from the North American Journal of Homoeopathy. 



VIII. 

SOME CONSIDERATIONS BEARING UPON 
PRACTICE WITH DYNAMIC ANTAG- 
ONISTS IN CASES OF POISONING BY 
DYNAMIC DRUGS. 



The dynamic property in a drug I should define 
as that by which the drug acts immediately upon vital 
processes, modifying their quality. This definition 
would not, I think, include any property of pure 
stimulants or of pure depressants (if pure depressants 
exist), for such stimulants and depressants I picture 
as modifying the force and rate but not the quality 
of vital processes.* I take it that when modifica- 
tion of vital processes is among the effects of chem- 
ical properties in a drug, immediate chemical changes 
(in tissues, secretions, or excretions) precede such 
modification; and that physical or chemical changes 

* See pp. 20 and 21 of this book, including footnote. 
(93) 



94 PRINCIPLES OF MEDICINE. 

caused by a drug's dynamic properties are secondary 
to its immediate effect upon vital processes. 

We can conceive of two kinds of dynamic antag- 
onism, the one quite distinct from the other. For 
present purposes let us call the one superficial antag- 
onism, and the other radical antagonism.* 

By superficial antagonism we mean an antagonism 
patent in the tissues or functions of the body, but an 
antagonism between drugs which operate through 
respectively different (either partly different or wholly 
different) channels. By radical antagonism we mean 
an antagonism not only apparent in the tissues or 
functions of the body, but one between drugs which 
act through respectively (in all particulars) the same 
channel. Let us for a moment consider whether 
there really is such a thing as radical antagonism. 

Much of medical literature seems to have been 
written from the standpoint of a belief in radical 
antagonism. That he who first formulated con- 
traria contrariis opponenda used the incomparable 
adjective contrarius seems to imply that he believed 
in radical antagonism,*]" and I suspect that many 

* We shall not here consider what might be called the 
dynamic antagonism between health and disease. See pp. 26 
and 27 of this book. 

f Superficial antagonism can obtain in greater or less 
degree, but radical antagonism could not. Contraria would 
be radically, i. e., incomparably antagonistic. 



SOME CONSIDERATIONS ETC. 95 

adopting that formula have also believed in such 
antagonism. I think that radical antagonism does 
not obtain — that could we, beginning with an antag- 
onism patent on the surface in any one function 
or organ, trace the action of drugs indefinitely 
far toward the prime cause of their surface effects, 
we should always find a lack of the requisites to 
radical antagonism. But the question of radical 
antagonism seems to me one perhaps not capable 
of conclusive demonstration by purely inductive 
methods. Whatever links in the modus operandi 
of a dynamic drug may have been recognized in 
an inductive investigation, there always must be 
unrecognized links beyond. To find, for instance, 
that through these muscle fibres, or through those 
muscle fibres, the condition of the pupil under a 
given drug is determined, is not to get at the root of 
the matter; nor is the root reached when we fix 
upon this or upon that nerve, or even nerve-centre, 
as the one through which the muscle fibres are 
affected. To demonstrate radical antagonism be- 
tween a mydriatic and a myotic would be to show 
them operating through respectively (in all particu- 
lars) one and the same channel. The word all in 
this connection includes some minutiae which we may 
still hope to discover, and some which we shall never 



<)6 • PRINCIPLES OF MEDICINE. 

discover. A characteristic of science is that it can 
never exhaust the minutiae of any phenomenon. We 
have simply expressed the opinion that radical an- 
tagonism does not obtain, and given a reason for 
thinking that its existence could not be inductively 
demonstrated. One who agrees to this reason may 
still think that such antagonism exists, though unde- 
monstrable.* To me it seems clear that there 
can be no such thing as radical antagonism; it 
would involve exact oppositeness, which I think is 
impossible between two things, — as is identity, f 

Any positive, pure, dynamic effect of a drug (by 
which I mean a dynamic effect producible in health) 
is abnormal.^ I would urge that the immediate 

*In this foot-note we depart for the moment from strict 
adherence to our definitions. Those definitions were* not 
formulated with a view to specially considering whether 
antagonism radical in kind may obtain in one organ or 
function, and not in all those affected by two antagonistic 
drugs; nor were they formulated with a view to specially con- 
sidering whether an antagonist acting less deeply than another 
may still be in kind radical. The impossibility of demon- 
strating radicalness of antagonism at any point would be such 
as I have just indicated. My opinion is that there is no such 
thing as radical antagonism between drugs at any point or 
in any degree. 

f See pp. 23 and 24 of this book (remembering that con- 
trarius as well as identical is incomparable), and footnote on 
pp. 28 and 29. 

:fThe fact that in medical literature positive, pure, dynamic 
effects of a drug are very frequently called physiological (in- 
stead of pathogenetic), or are described under the heading 
physiological action, seems in part a result of, and in part 
responsible for, a lack of recognition of the fact that such 



SOME CONSIDERATIONS ETC. 97 

resultant of dynamic forces in two superficially antag- 
onistic drugs can never be intrinsically the same 
condition found in health, — that, though this result- 
ant may look like what obtains in health, the same it 
is not. To illustrate: Take a normal pupil; dilate 
it with a mydriatic, and then contract it with a 
superficially antagonistic myotic: this pupil may 
now look as it did before your experiment began, 
but is a pupil normal when its condition is the 
immediate resultant of superficial antagonism be- 
tween two drugs ? I think not. Indeed, is not 
this pupil farther from normal than it would be 
under the influence of either one alone of these 
drugs, even though it would then be dilated or else 
contracted ? If the views here expressed or im- 
plied are correct, it follows that in rational p 

any benefit which we can reasonably expect 
from superficial antagonism must be something else 
than a direct re-establishment of normal condi- 
tions. There is, I believe, no such thing as a 
of ' centrar. 



effects are not normal, but abnormal. Is not the science of 
drug pathogenesy as distinct from the science of physi: 
as is the science of pathology : Is it not as confusing to call 
pathogenetic effects physiological, as it would be to call patho- 
logical effects physiological ? See p. 59 lincluding footnote). 
* For a definition of the term rational pr>_ - here 

used, see p. 56 of this book 

f.uding footnote + ) and p. 27 of this book. 



98 PRINCIPLES OF MEDICINE. 

Perhaps we may in some circumstances reason- 
ably expect to ameliorate a patient's condition, or 
even to save his life, by effecting superficial antago- 
nism in a function or organ necessary to life (<?. g., 
the respiration or the heart); but it seems possible to 
attach an entirely false significance to the fact of 
superficial antagonism in some function or organ not 
necessary to life. To illustrate I still again cite 
drug effects upon the pupil. Bartholow says he 
agrees with Schmiedeberg "that no example of 
physiological antagonism could be more exact" than 
that afforded by muscarine and atropine. Leading 
up to the statement that "viewed from all sides, 
these agents are exactly antagonistic," he is citing 
points of antagonism between them when he says: 
"On the eye, the contracted pupil of muscarine, due 
to stimulation of the circular fibres innervated by the 
third nerve, is opposed by the dilated pupil of 
atropine, produced by stimulation of the radiating 
fibres, innervated by the sympathetic."* If, in 
treating one poisoned by muscarine, our immediate 
object were (as in the common ophthalmological 
practice with mydriatics) simply to dilate the pupil, 
it might be of no moment whether it was through 

paralysis of the third nerve and circular fibres, or 

*Bartholow's Hypodermatic Medication, Fifth edition, 
pp. 311, 312. 



SOME CONSIDERATIONS ETC. 99 

through stimulation of the sympathetic nerve and 
radiating fibres, or through a combination of these, 
or in still some other way, that the dilatation was 
effected. But in poisoning by muscarine the con- 
traction of the pupil is not what harms the patient, 
and there is no advantage in merely dilating it. If 
it be true that the contraction from muscarine is 
effected through a channel other than that through 
which the dilatation from atropine is effected, it may 
fairly be doubted whether this contraction and this 
dilatation have any bearing upon the question 
whether atropine will benefit a patient poisoned with 
muscarine. We tend to the conclusion that, while 
it may sometimes be useful to establish antagonism 
in a function upon which life depends (as that of 
respiration), the establishment of antagonism in a 
function or organ not essential to life (e. g., the 
pupil) may be useless. 

I suppose that any drug promising much as a 
dynamic antagonist in case of drug poisoning, is 
itself capable of producing serious poisoning. In 
passing I simply allude to the generally recognized 
possibility of seriously, even fatally, embarrassing 
one function or organ with a drug used for the sake 
of antagonism in some other function or organ. 
While this possibility is, as I say, generally recog- 



IOO PRINCIPLES OF MEDICINE. 

nized, the recognition is, I think, more cordial in 
theory than in practice. I think that often due cau- 
tion is not observed in attempts to relieve with 
dynamic drugs persons seriously poisoned. 

Conclusions at which we arrive, or toward which 
we tend, are: ist, That radical antagonism between 
dynamic drugs does not obtain. 2nd, That any 
benefit which we can reasonably expect from super- 
ficial antagonism between dynamic drugs must be 
something else than a direct re-establishment of 
normal conditions. 3rd, That in case of poisoning 
with dynamic drugs it may be useless to effect 
dynamic antagonism in functions or organs not 
necessary to life. 4th, That we should not with- 
out the greatest caution attempt to dynamically 
antagonize dynamic drug poisons. 



IX. 

AN ADDRESS TO SOME STUDENTS 

IN A NON-HOMCEOPATHIC 

MEDICAL COLLEGE. 



IX. 



AN ADDRESS TO SOME STUDENTS IN A 

NON-HOMCEOPATHIC MEDICAL 

COLLEGE.* 



i. Do you believe in trying to ascertain the causa- 
tion of disease, and in using the knowledge thus gained 
as a basis for treatment? 

Any cause knowable to inductive science other- 
wise than in effects is proximate: this is true whether 
we speak of causes of disease or causes of any other 
phenomenon. I believe in searching out and avoid- 
ing or removing proximate causes of disease by any 
means not harmful to patients. 



-During the college year 1889-90 I accepted an invitation 
from some students in the Department of Medicine and Surgery 
in the University of Michigan to speak to them upon the sub- 
ject of homoeopathy. They handed me their written questions 
some days before the time appointed for our meeting. Their 
questions and my answers constitute this address. 

(103) 



104 PRINCIPLES OF MEDICINE. 

Proximate causes of disease are various, but 
there is one factor constant in the production of 
those effects in which alone (aside from proximate 
causes) disease is knowable to inductive science: 
that one constant factor is life. I shall, for our 
purposes this evening, use the word cure as appli- 
cable only where, as an immediate result of the 
medicine used, abnormal vital processes become 
normal.* Any measure, then, which deals immedi- 
ately with proximate causes of disease fails of being 
curative. I believe that it would be futile to attempt 
to learn so much about disease, as one would have 
to know in order to cure without the guidance of a 
law of nature, f 

To some of you it may at first seem unjustifiable 

to use the word cure with a restricted meaning as we 

are at present doing. Words are means by which to 

express ideas, and we cannot, to best advantage, 

discuss various principles upon which practice may 

.be based, if we use without definition the same word 

to express recovery with no treatment, recovery in 

spite of harmful treatment, results of practice based 

upon one principle, and results of practice based 

upon another principle. J The cure at which homoe- 

* See pp. 9, 16, 61 (including footnote), 66, 67, 89 and 90. 

f See p. 21 of this book. 

\ See pp. 89 and 90 of this book. 



AN ADDRESS TO SOME STUDENTS. 105 

opathic treatment aims is entirely distinct from 
results at which, for instance, hygienic treatment 
aims; and it seems desirable while discussing homoe- 
opathy, either to limit the meaning of cure, or else 
to introduce some entirely new word. I think that 
the idea cure, as held by homoeopathists, is repu- 
diated by many practitioners of medicine who are 
not homoeopathists. 

2. Do you believe that practice based on any other- 
principle than iC Similia similibus curantu?'^ ever cured 
disease ? 

I think you will be more apt to understand 
homoeopathy, if you fix in your minds the idea that 
homoeopathic treatment is invariably and essentially 
treatment of the patient, and aims at the cure of the 
patient* It is with a definite and, I believe, correct 
idea that many homoeopathists object to expressions 
such as cure disease, treat disease honiaopathically , etc. 

That various practices based on principles other 
than siniilia may be useful I have no question. 
Bear in mind the meaning with which we are using 
cure, and you may understand me when I say that I 
do not believe any practice not homoeopathic ever 
cured a patient. 

3. If disease is to be treated ' symptomatic ally, why 
* See p. io, 11 and 17 of this book. 



Io6 PRINCIPLES OF MEDICINE. 

should the physician trouble himself to lear?i about 
physiology, pathology, chemistry, urinalysis and kin- 
dred sciences? 

Permit me, before discussing this question, to 
amend it so that it shall read: If patients are to be 
treated symptomatically, etc. If by symptomatically is 
implied that among disease effects subjective symp- 
toms only are admissible as indications for a homoeo- 
pathic remedy, I say that I do not believe in this 
restriction. I believe that any unmodified disease 
effect (subjective or objective) may properly find 
place among indications for a particular remedy as 
homoeopathic. 

In answering this question I shall assume that by 
physiology you mean the inductive science of normal 
vital processes as known in their proximate causes 
and in effects, and that by pathology you mean the 
inductive science of diseased vital processes as 
known in their proximate causes and in effects. Now, 
the only possible way of recognizing, as abnormal, 
disease effects ^subjective or objective) or unmodi- 
fied dynamic drug effects (subjective or objective) is 
by comparison with the effects of normal vital pro- 
cesses. Not only is a knowledge of physiology and 
pathology essential to the practice of homoeopathy 
at any given time, but endless advancement in those 



AN ADDRESS TO SOME STUDENTS. 107 

sciences is among the essentials to endless advance- 
ment in the art of practicing homoeopathy.* Nothing 
could be more erroneous than the notion that to 
practice homoeopathy is to ignore science; were it not 
for the sciences of physiology, pathology and materia 
medica pura, it would be impossible to even once 
intelligently prescribe a medicine as homoeopathic. 

As regards the sciences chemistry and urinalysis, 
I would say that only through them can we become 
acquainted with some disease effects and with some 
perhaps dynamic drug effects, which disease effects 
and drug effects may be of value among data for 
the selection of a homoeopathic remedy. To illus- 
trate: albumen and casts in the urine are, perhaps, 
among unmodified dynamic effects of some drugs. 
Furthermore, the science chemistry acquaints us 
with various facts upon which useful, non-curative 
treatment may be based. t The use of urinalysis 
in prognosis may be mentioned. 

4. Would nol the perfect homceopathic medicine be 
such an one as would produce all the symptoms in the 
disease for which it is given? 

The word like is not synonymous with the word 

identical. Homoeopathy is not isopathy. % Let me 

* See pp. 29 and 30 of this book, 
f See p. 20 of this book. 
\ See p. 23 of this book. 



108 PRINCIPLES OF MEDICINE. 

amend your question so that it shall read: Would 
not the perfect homoeopathic medicine be such one as 
would produce effects similar to all those of the disease 
by which it is indicated? An ideal homoeopathic 
medicine would produce effects similar to all those 
of the disease by which it is indicated. Remember, 
however, that similar is a comparable adjective,* 
and that a drug may be more or less curative in 
proportion as it is (in unmodified dynamic effects) 
more or less similar to a disease. In selecting a 
similar one may consider similarity between the 
total disease effects and the total drug effects, but 
accord special weight to similarity in unusual degree 
between individual disease effects and individual 
drug effects. 

Either your phrase the perfect homoeopathic medicine 
or my phrase an ideal homoeopathic medicine may serve 
as occasion for the following remark: In any given 
case no medicine could be so homoeopathic that one 
more homoeopathic was not predicable, which Tfact is 
essential to the belief that the art of practicing 
homoeopathy is capable of endless development. f 

5. Do you aim to give, according to this principle ', 

medicines which do produce in the healthy person the 

* See pp. 24, 94 (including note f ), and 96 (including 
note f), of this book. 

f See pp. 29 and 30 of this book. 



AN ADDRESS TO SOME STUDENTS. IO9 

same pathological conditions as are present in tlte 
disease / 

As I have just said, like is not identical — homoe- 
opathy is not isopathy. I, therefore, amend your 
question so that it shall read: Do you aim to give, 
according to this principle, medicines which no produce 
in the healthy person pathological conditions similar to 
those produced by the disease? A homoeopathic 
medicine is one which, taken in health, does or 
won Id produce pathogenetic conditions (subjective or 
objective) similar to those produced by the disease 
present. I say, "does or would.''' There is no 
trouble whatever about inducing in perfectly harm- 
less provings a multitude of definite drug effects; but 
we cannot, of course, seriously or fatally poison 
human beings for the sake of learning a drug's 
pathogenetic effects. Very many of the most marked 
unmodified dynamic drug effects in human beings, 
either objective (as tissue changes in the viscera) or 
subjective are known to us only from criminal 
poisonings, or from accidental poisonings, among 
which latter are cases in which poisons when used as 
medicines have produced serious (sometimes fatal) 
consequences. There is on record, aside from what 
we technically call provings, a vast deal regarding 
the most extreme subjective and objective pathoge- 



IIO PRINCIPLES OF MEDICINE. 

netic effects of drugs in human beings. From what 
is known of comparative drug pathogenesy we may 
sometimes with considerable confidence infer from 
experiments upon the lower animals what would be 
in human beings effects which we should not be 
justified in producing in them by one or another 
drug. Effects thus inferred may be accorded a 
conditional place when one is considering the claim 
of a drug as homoeopathic in practice upon human 
beings. From various data we may infer that a drug 
may have such and such pathogenetic effects, — as 
when we infer from its action on one organ or func- 
tion what its action on another organ or function 
may be. To the extent that a practice is based 
upon such inference it of course is not homoeopathic, 
if the inference is erroneous. 

6. Does the homoeopath of the present day practice 
according to the principles laid down by Hahnemann 
in his Organon ? 

7 . If not, why not ? 

8. If not, in what respects have the principles 
changed, and why have they so changed ? 

These three questions I shall consider together, 
beginning with the remark that principles never 
change. It is quite possible that Hahnemann re- 
garded as principles some things which are not prin- 



AN ADDRESS TO SOME STUDENTS. Ill 

ciples. Of various principles there is but one which 
is to-day recognized by all homoeopathists, and is 
at the same time distinctive of homoeopathy; that 
principle is what the word homoeopathy implies, viz. : 
Similia similibus curantur. In accepting that prin- 
ciple homoeopathists are at one; regarding various 
other matters they are not at one. Conspicuous 
among the questions upon which homoeopathists 
differ among themselves, is that of dosage. I think 
that the opinion of most homoeopathists to-day is 
that dosage is still a matter of experience only. An 
idea which some homoeopathists have expressed is 
that there is a still undiscovered law of dosage. 
This idea strikes me as reasonable; indeed, would it 
not be unreasonable to believe that there is not and 
cannot be a law of dosage ? 

Do not suppose that homoeopathists regard similia 
similibus curantur as a thing invented by Hahnemann; 
no, we regard it as a law of nature — a principle true 
in the very nature of things, and discovered, not 
invented, by man. 

9. Do you believe that the power of a medicine to 
modify disease lies in its chemical affinities, or is it due 
to some power which uses the ?nedicine as a vehicle? 

Chemical affinities are not matter: they use matter 
as a vehicle. So of physical properties — so of 



112 PRINCIPLES OF MEDICINE. 

dynamic properties: none of these properties is 
matter — each of these properties uses matter as a 
vehicle. A medicine maybe used for the sake of its 
physical properties (e. g. demulcent drinks), or for 
the sake of its chemical properties (<?. g. acids or 
alkalies to change chemical reaction of gastric juice 
already in the stomach), or for the sake of its 
dynamic properties. Dynamic properties in a drug 
are those which render it an immediate modifier of 
the quality of vital processes. Please understand 
the force of the word qicality in this definition: 
I shall illustrate it by what I suppose is true of 
effects upon an adult's heart of, on one hand, 
half an ounce of brandy — and, on the other hand, 
ten drops of the tincture of digitalis. The brandy 
would simply affect the force and rate of the 
heart's action: if the quality of that action had 
previously been normal, it would still be nor- 
mal; if the quality had been abnormal, it would 
still be abnormal. The digitalis would modify not 
only the force and rate but also the quality of the 
heart's action* 

The reason why we homoeopathists talk so much 
about the dynamic power of drugs is that we believe* 
a drug can be curative only by reason of its dynamic 



*See pp. 20, 21 (including foot-note) and 93 of this book. 



AN ADDRESS TO SOME STUDENTS. II3 

properties. Homoeopathy does not speak of drugs 
otherwise than as dynamic agents.* 

10. Do you believe that trituration adds any 
power to a medicine other than to make it more quickly 
and easily assimilated? 

I rather think that trituration affects a drug (as 
a dynamic agent) merely by subdividing particles, 
and thus putting them into a condition in which their 
dynamic properties are more effective. I question, 
by the way, whether a medicine in inducing its 
dynamic effects is assimilated. 

11. Supposing that some definite chemical poison 
were proven to be the cause of an acute disease, woula 
you {a) still treat the disease symptomatically, or 
would you {V) try to find and use a chemical antidote? 

Curative treatment is invariably a treatment of 
the patient with a remedy homoeopathic to disease as 
manifested in him. Curative treatment is never an 
immediate attack upon a proximate cause of disease. 
If I proposed to cure a patient in the circumstances 
supposed, I should treat him with the medicine which 
seemed most homoeopathic to disease as manifested 
in him. Now, aside from curative treatment, if I 
definitely knew that a chemical poison were the 
proximate cause of his disease, — if, too, I accurately 

* See pp. 21 and 22 of this book. 



114 PRINCIPLES OF MEDICINE. 

knew the chemistry of that poison, and accurately 
knew a chemical antidote, — and if, moreover, I knew 
that the chemical antidote would be harmless to my 
patient, I should have no objection to trying such 
antidote. Successful ^treatment with that antidote 
would not be curative. 

I take it that this question is asked in view of the 
theory, perhaps we could safely say fact, that in some 
instances disease is due to bacteria and ptomaines as 
proximate causes. I understand that those who 
have most studied this particular subject regard as 
unpromising any attempt to kill bacteria or to 
chemically antidote ptomaines by introducing germi- 
cides or chemicals into the patient's circulating 
blood, without harming the patient. I am not much 
drawn toward schemes for administering internally 
chemical antidotes to chemical poisons in the circu- 
lating blood or other living tissue of the body, but I 
shall be glad if any who are so drawn shall in the 
future have developed some useful practice. 

12. Do you think that a medicine can act as a 
chemical antidote when given in the third dilution on 
a scale of X, when the poisoning has been sufficient to 
produce symptoms such as are found in the severer 
forms of scarlet fever, small-pox, and septicaemia? 

As a chemical agent, the force of one drug in its 



AN ADDRESS TO SOME STUDENTS. 115 

third decimal dilution might differ greatly from the 
force of another drug in its third decimal dilution. 

Upon inquiry I learn that this question is asked 
in view of ptomaines. To confidently and finally 
answer to it either yes or no, with, among other 
things, a view to the patient's safety, would imply a 
greater knowledge than I possess (and, I think, than 
anyone possesses) of various sciences. This question, 
by the way, has nothing whatever to do with the 
subject of homoeopathy. 

Your allusions to "the germ theory of disease'' 
suggest the following: I think we should be safe in 
concluding that germ killing by internal administra- 
tion of germicides, could never rank very high 
among arts. Supposing that there is ahead of us the 
discovery of a germicide with which it will be possible 
and practicable to, for instance, by internal admin- 
istration kill typhoid germs; what are we to do for 
cur patients meantime? Furthermore, it is suppos- 
able that, when such a germicide had become known, 
the art (so far as concerns typhoid fever) should be 
perfect. One reason for my belief that the practice 
of homoeopathy will forever rank very high among 
arts is, that it recognizes a constant law under which 
a remedy may be more or less curative, and under 
which the art is capable of endless development; for 



Il6 PRINCIPLES OF MEDICINE. 

in no case could a medicine be so homoeopathic that 
one more homoeopathic was not predicable. 

13. In your provings do you refer to the symptoms 
produced by dilutions, moderate sized, or decidedly 
toxic doses? 

Proving is used by homoeopathists as the techni- 
cal name for an experiment in which a dynamic 
poison is given (in whatever dose) to a human being 
in health with a view to ascertaining what are 
unmodified dynamic effects of that poison: obviously 
such experimentation can be practiced only within 
limits. Aside from provings, there is on record a 
vast deal regarding unmodified dynamic effects in 
human beings of poisons taken in such quantities as 
to induce alarming or fatal effects. I believe it is 
proper that any unmcdified dynamic effect producible 
by a poison in human beings should have a place in 
the materia medica pura, and should have due weight 
when one is considering the use of that poison as a 
curative medicine. 

14. Do' you believe that certain drugs have 
a more potent action upon disease Afunctional or 
structural} affecting one side of the body than upon 
the other? 

If so, how do you explain the belief that medicines, 
entering the system through the same channels, passing 



AN ADDRESS TO SOME STUDENTS. 117 

into the circulation have the power to select the right 
or left side of the body {as the case may be) ? 

Let me preface my answer to these two questions 
by remarking that whether a drug may affect one 
side, rather than the other, of the body is a question 
of great interest, but is entirely aside from a question 
whether similia similibus curantur is the law of cure. 

From the form in which these two questions are 
put I infer that they are asked by one who thinks 
there is a priori reason for believing that a drug's 
dynamic effects cannot be evidenced in one side, 
rather than the other, of the body. Why should they 
not ? Of food which enters the stomach why does 
one particle go to the bones, another to the muscles, 
another to the nerves, another to the hair, etc.? 
I do not know in detail; nor does any man. Why 
are conspicuous dynamic effects of one drug mani- 
fested in bones — those of another in nerves — those of 
another in the kidneys — and those of still another in 
the lungs ? Again, I do not know in detail. That 
the functions of one side of the body are not identi- 
cal with those of the other side may, I suppose, be 
taken as proved. Why are most people right handed? 
I suspect that there is some definite reason for the 
prevalence of right-handedness — that it is not simply 
a matter of chance. Do you think there is any a 



Il8 PRINCIPLES OF MEDICINE. 

priori ground for concluding that the center for one 
function may not be in one hemisphere of the 
cerebrum, and the center for another function in the 
other hemisphere? Is Broca's center usually on the 
left side? The foregoing may raise in your minds a 
doubt as to whether there is any a priori reason 
whatever for assuming that a dynamic poison may 
not affect one side, rather than the other, of the 
body. Let us, then, regard the question whether a 
drug may affect one side, rather than the other, of the 
body as merely a question of fact; and to determine 
this question of fact I know of no way more promis- 
ing than to consider the evidence already on record, 
and to further experiment with drugs upon living 
beings in health with a view to observing what, as 
matter of fact, are unmodified dynamic effects pro- 
ducible by drugs. 

A part of what I regard as conclusive argument 
that one cannot intelligently cure unless under guid- 
ance of law is the fact that, excepting in proximate 
causes, inductive science can know drugs, as dynamic 
agents, or disease only in effects;* this, though dis- 
ease effects may be proximate causes of other dis- 
ease effects. To the question: if a drug's dynamic 
effects may be manifested on one side, rather than on 

* See pp. 21 and 22 of this book. 



AN ADDRESS TO SOME STUDENTS. II9 

the other, of the body, how do you explain the fact? I 
should reply: I do not explain it. 

15. If you gave quinine in malarial fever, in what 
doses would you give it? Do you give any form of 
mercury in syphilis? What symptoms call for its use 
according to the principle of " Sim ilia similibus 
curantur/" 

If a homoeopathist concludes on purely a posteriori 
grounds (as I do not) that quinine is of benefit to all 
malarial patients, he is entirely at liberty to empir- 
ically give quinine to such patients in whatever 
doses he thinks experience has shown most useful. 
Aside from this purely empirical practice, a homoe- 
opathist may give quinine to a malarial patient in the 
hope of killing germs in the circulating blood.* 
Again: a homoeopathist may give quinine to a 
malarial patient in the hope of supplying to the 
tissues a substance which was present in them in 
health, but is absent from them under the influence 
of malaria; I believe, however, that the latest reports 
do not encourage one in this hope.t Still again: 
there are, I believe, some homoeopathists who regard 
cinchona (or quinine) as homoeopathic to malarial 

* See Biddle's Materia Medico, and Therapeutics, thir- 
teenth edition, p. 159. 

ISee H. C. Wood's Therapeutics : its Principles and 
Practice, ninth edition, p. 639. 



120 PRINCIPLES OF MEDICINE. 

fever in its commonest manifestations. I do not 
so regard it. If I were giving pure quinine to a 
malarial adult, I should be apt to begin with 2 gr. 
doses. I probably should not give pure quinine, 
until I had first tried the first centesimal trituration 
of china (/. <?., cinchona). 

You ask: do you give any form of mercury in 
syphilis? I should very cordially disapprove of a 
routine practice of giving to all syphilitic patients 
mercury in amounts sufficient to induce extreme 
pathogenetic effects, but I agree with those who 
believe that to svphilis in many of its manifestations 
mercury (either the metal itself or various of its 
salts) is more or less homoeopathic. Among disease 
effects by which it may be indicated as homoeopathic 
to syphilis I mention general cachexia with abortions 
or premature births, swelling of lymphatic glands, 
swelling and inflammation of periosteum and bones, 
some cutaneous eruptions and falling of the hair. 
Regarding similar effects from mercury, which are 
markedly induced among those constantly exposed 
to mercurial vapors (as are those engaged in various 
arts), there is considerable record. Of such records 
I know none better than that contained in Stille's 
Therapeutics and Materia Medica.* Read all that 

* Fourth Edition, Vol. II. 



AN ADDRESS TO SOME STUDENTS. 12 1 

Stille says regarding the pathogenetic effects of 
mercury, and you will find your present question 
(what indicates the drug as homoeopathic to syphilis?) 
pretty well answered. From what he says I quote: 
"It has long been a question, and is one not yet 
"fully determined, how far mercury may operate to 
"produce disease of the bones. The tendency of 
"syphilis to develop these affections is well known. 
"and also the great frequency of their occurrence in 
"syphilitic cases treated by mercury, yet it is certain 
"that they sometimes follow the administration of 
"this medicine in cases wholly free from a syphilitic 
"taint. Mercurial nodes, it is said, precede the ulcers, 
"and the destruction of tissue proceeds from with- 
"out inwards. They most frequently are seated in 
"the spongy bones of the base of the cranium, or in 
"the ends of the long bones. (Canst at f). 

"Mr. Spence reports the case of an old woman 
"who had never been affected with syphilis, but had 
"taken large quantities of mercury. After suffering 
"from pains in the head, ulceration began in the soft 
"parts over the os frontis, involving the bone and 
"dura mater, and ultimately exposing the brain. 
"After death an abscess was found in the substance 
"of the brain." 

The following is from S. O. L. Potter's Materia 



122 PRINCIPLES OF MEDICINE. 

Medica, Pharmacy and Therapeutics:* "Indeed, as 
"Dr. Ringer said in the earlier editions of his Hand- 
-book of Therapeutics, the phenomena produced by 
"mercury are singularly similar to those which will 
"result from syphilis, and the serious symptoms 
"known as secondary and tertiary syphilis can be pro- 
duced both by syphilis and by mercury." Wharton 
and Stille in their work on Medical Jurisprudence^ 
quote a statement that " 'Syphilis alone can be con- 
founded with chronic mercurial poisoning. ' ' My 
impression is that not only in various books on 
materia medica, but also in periodical medical 
literature you may find, both from homoeopathists 
and from non-homceopathists, a good deal regarding 
the similarity between effects of syphilis and unmodi- 
fied dynamic effects of mercury in human beings, 

1 6. If you do not give mercury in spy hi/is, do you 
give minerals in any disease? Do you give opium in 
any form? 

There are many minerals which are dynamic 
poisons: some of them have been conspicuously 
used as homoeopathic ev$r since homoeopathy 
became known. 

Opium in various dilutions or triturations has 



* Page 220. 

f Fourth Edition, Vol. II, p. 210. 



AN ADDRESS TO SOME STUDENTS. J 23 

been much used as homoeopathic, where disease 
effects were more or less similar to unmodified 
dynamic effects producible by opium in human 
beings. 

Aside from curative treatment, one may use 
opium as an anodyne. /. e. to benumb a patient, and 
render him insensible to pain. Without regard to what 
is the proximate cause of a given pain, or to what 
part of the body is affected, you sometimes may by 
inducing in your patient more or less insensibility as 
a pathogenetic effect of opium (or morphine) render 
him insensible to pain. This pathogenetic effect of 
opium may be precisely the same in a person diseased 
as in a person well, and to induce this effect in a 
patient is to poison him to some degree — an entirely 
different thing from curing him. I believe it is 
sometimes useful to cautiously and within bounds 
thus poison a patient with opium or morphine; but 
I need not tell you that when the immediate object 
of our practice is to poison a patient to some 
degree, we should be exceedingly careful not to 
harm him.* 

17. What relation do you think that Homoeopathy 
as practiced at present bears to the so-called old school 
practice? 

* See p. 59 of this book. 



124 PRINCIPLES OF MEDICINE. 

My belief is that similia similibus curantur is a 
law of nature, and I answer this question from my 
standpoint in that belief. The practice of homoe- 
opathy, at any given time, is the use of medicine 
under guidance of similia, and at no time can that 
practice (unless incidentally) bear any relation what- 
ever to any practice with medicines to which similia 
has not been the guide. 

One may frequently be asked, don't you think 
that the two schools are coming nearer together? 
That to-day homoeopathists are, more than formerly, 
availing themselves of various practices which are 
distinctly not homoeopathy, and that the so-called old 
school has discontinued many harmful practices, and 
is in some instances empirically using medicines 
which are somewhat homoeopathic is true: but these 
resemblances are all on the surface of things, where- 
as the essential of homoeopathy {similia as law) is not 
on the surface, and it does not occur to me what 
could be adduced as evidence that the so-called old 
school as a body is in the least disposed even to 
admit that perhaps similia f s claim is just. 

Each of you may have heard from one or another 
so-called old school physician an expression of the 
opinion that there should be no distinct bodies in 
medicine — that all properly qualified physicians 



AN ADDRESS TO SOME STUDENTS. 125 

should belong to one body and fraternize in societies. 
Such expressions on the part of individuals are 
interesting and, I think, significant; but there can 
be no live question regarding fellowship of homce- 
opathists and the so-called old school in a common 
society, so long as the so-called old school as a body 
is unwilling to fraternize with any man until he shall 
have declared, over his signature or by word of 
mouth, that he does not believe in or intend to 
practice homoeopathy, or shall have declared some- 
thing to that effect. Membership in a society cannot 
make or unmake a homceopathist, and I take it that 
no kind of co-operation between the two bodies can 
obtain without provision for absolute freedom as to 
all thought and work relating to homoeopathy. If I 
correctly understand the existing condition of things, 
the so-called old school as a body, having constituted 
itself an agent exceedingly powerful for the crushing- 
out of homoeopathy and for obstruction to its pro- 
gress, is still exerting itself to accomplish this work 
through legislation, through the press and through 
the influence of its individual members. I raise no 
question but that the so-called old school is proceed- 
ing in this matter in the belief that the measures it 
adopts are calculated to subserve the best interests 
of mankind and of the medical profession. It may 



126 PRINCIPLES OF MEDICINE. 

be presumed that the so-called old school will as a 
body make the fact known, if at any time it shall 
have come to pass that they want the co-operation 
of homoeopathists in matters aside from homoeopathy. 

If you are in the habit of thinking that homoe- 
opathists are exclusive, and that the so-called old 
school is not, please consider whether your views 
upon this point should be revised, or perhaps aban- 
doned and replaced by different views. 

From some of your questions I infer that perhaps 
each of you might say what one or another of you 
has said to me regarding himself, viz. : that he has 
not given any particular attention to the subject of 
homoeopathy, and feels that really he does not know 
much about it. If you do not know much about 
homoeopathy, the fact is not surprising; nor would 
I allude to it in any reproachful way; your thought 
and studies have lain in other directions, and I am 
exceedingly glad that you have in the subject of 
homoeopathy an interest such as the circumstances 
of my presence with you this evening imply. The 
bearing of this paragraph is upon what may still be 
a question in your minds, viz. : whether in the 
present state of opinion regarding homoeopathy, it 
is wise to exact as prerequisite to admission into 
societies intended not only for physicians of age 



AN ADDRESS TO SOME STUDENTS. 12 J 

and experience, but also for physicians who have 
just received their degrees, any declaration, pledge 
or promise which could embarrass one in determin- 
ing his attitude toward homoeopathy. 

I do not know that in the whole controversy over 
homoeopathy there has developed anything more 
remarkable than the proposition that homceopathists 
should retain the idea homoeopathy, and annihilate 
the word hom&opathist. In an address before the 
Rhode Island Medical Society, in 1886, upon "The 
past, present and future Treatment of Homoeopathy, 
Eclecticism, and Kindred Delusions which may 
hereafter arise in the Medical Profession, " Dr. Henry 
I. Bowditch said: " Let members of either of these 
"sects join our State Societies, provided they prove 
"to the State Examiners or Censors that they have 
"studied medicine a proper length of time and are 
" able to pass the examination required of all appli- 
cants for admission, and provided moreover they 
"agree to cease to call themselves by any peculiar 
"name because they desire to enroll themselves as 
"members of our time-honored profession." I 
cannot think that the least improvement upon the 
present state of affairs would be effected by an agree- 
ment among homceopathists not to call themselves 
homceopathists. 



128 PRINCIPLES OF MEDICINE. 

The words homceopathy, homoeopathic, homoe- 
opathist (or homoeopath) occur, as matter of course, 
in Dr. Bowditch's address, in your questions to me, 
and in my answers to you: to abolish any one of 
those words, were such a thing possible, would, to 
say the least, seriously embarrass both homoeopa- 
thists and the so-called old school in advocating 
their respective views regarding the claim of similia. 
To rne it seems probable that the name homoeopathist 
will distinguish those who believe in similia from 
those who do not, until a time when similia is 
generally recognized, and when physicians are, 
as matter of course, homceopathists: after such 
time the word homoeopathist would perhaps be 
superfluous. 

How much does the so-called old school practice 
of to-day resemble homoeopathy? I do not propose 
telling you that the so-called old school practitioners 
sometimes with ipecac relieve a patient of vomiting, 
and sometimes with jaborandi relieve him of sweat- 
ing, or to search out various instances in which they 
rise medicines which are more or less homoeopathic. 
What I do propose telling you is that, so far as I am 
aware, such practices in the so-called old school are 
purely and simply empirical and in no recognition 
whatever of similia. Farquharson says of ipecacuanha: 



AN ADDRESS TO SOME STUDENTS. 1 29 

"A most remarkable fact in the action of this drug is 
its power, when given in small doses, of checking 
vomiting. ... At present this must be looked 
upon as one of the enigmas of therapeutics."* Would 
it not be reasonable to let similia play some part in 
the solution of this particular enigma? I could 
easily construct from writings upon therapy by 
Brunton, Ringer, Bartholow and various representa- 
tive men in the so-called old school many an enigma 
to which simi/ia would seem a more or less satis- 
factory answer; but I do not know from what man 
in the so-called old school I could cite an intimation 
that perhaps similia is what we believe it to be, viz. : 
the only possible law of cure — a law to which should 
be accorded a place of command — the only law which 
can point out the way of future progress indurative 
medicine. You may frequently hear that there are 
various laws of "cure" — that similia is one of them, 
and that this has been recognized in the so-called 
old school since the time of Hippocrates. One can- 
not speak of various laws of "cure," if by "cure" he 
mean the definitely specified thing which we this 
evening mean by cure. What practical effect is there 
in the so-called old school of any belief that similia 

* Farquharson's Thei'apentics and Materia Medica, 
second American edition, adapted to the U. S. Pharmacopoeia 
by F. Woodbury, M. D., p. 291. 

9 



130 PRINCIPLES OF MEDICINE. 

is even a law of "cure"? A law is of no use in so 
far as it is merely recognized a posteriori; knowledge 
of a law becomes useful when that law is recognized 
as a priori ground for action. Does any one of you 
know a so-called old school physician who ever said 
to himself: in my treatment of this patient I shall be 
guided by similia, one of the laws of "cure"? My 
belief is that in the so-called old school as a body 
there is no useful recognition whatever of similia as 
even a law of "cure." 

You may hear a so-called old school physician 
say that he is willing to use a homoeopathic medicine 
on sufficient evidence that it is useful. To base 
practice simply on evidence is empiricism. If in a 
given case [ prescribe a medicine, simply because 
Hahnemann or Boenninghausen or some one else 
attributed a cure to the same medicine in like 
circumstances, the medicine may be more or 
less homoeopathic to disease as manifested in my 
patient, but my selection of it is purely empirical. 
To intelligently select medicines because of their 
homoeopathicity, involves in each case a study of 
disease as manifested in effects and a study of the 
pathogenetic dynamic power of drugs as it is 
manifested in effects. In a practice of simply 
following precedents there can be no intelligently 



AN ADDRESS TO SOME STUDENTS. 131 

devised progress: in practice under guidance of 
similia there may be endless progress intelligently 
devised. 

I have quoted Farquharson to the effect that the 
power of ipecac, when given in small doses, of 
"checking vomiting" must at present be looked upon 
as one of the enigmas of therapeutics. It is intrinsic 
in empiricism to regard benefit derived from any 
drug in any circumstances, as an enigma. When one 
of these enigmas is correctly solved, future practice 
based upon the facts which correctly explain the 
enigma is not empiricism, for it is based upon a 
priori reason. To correctly explain an accepted 
practice empirically hit upon may help us to a 
generalization upon which other practices may be 
based, but as regards the particular practice explained 
the explanation is of no use whatever. For instance: 
if one accepts a posteriori as facts, that quinine is the 
medicine for malarial patients, and that mercury is 
the medicine for syphilitic patients, enough said: — 
so far as concerns the treatment of these patients, if 
one knows the medicines for them, it makes no 
difference why these medicines help, and it would be 
merely a useless accomplishment to be able to ex- 
plain why they help.* It is two hundred and fifty 

* See p. 54 of this book, 



I32 PRINCIPLES OF MEDICINE. 

years since cinchona was introduced into Europe as 

of use in practice among malarial patients; how long 

before that it had been used in Peru I do not know: 

it is perhaps more than three hundred and fifty years 

that in Europe mercury has been regarded as of use 

in practice among syphilitic patients, and it is said 

that syphilitic patients were treated with mercury by 

the Malabar physicians as early as the ninth century.* 

Those who empirically follow the practices cited 

(with cinchona or quinine, and with mercury) are 

to-day more or less interested in attempts to solve 

the enigmas to which these bits of empiricism have 

respectively given rise. In these two instances is 

conspicuously illustrated the fact that empiricism 

regards the practice of medicine as an inductive 

science, and not as an art based upon a knowledge of 

subsidiary sciences. To settle down content with 

empiricism is, I believe, to become a dead-weight 

to all effort at intelligently devised improvement in 

the art of practicing medicine. 

I wish to make a few suggestions which I think 

you may find useful, if in your investigation of 

homoeopathy you are approaching the subject by 

observing the practice of homoeopathists. Much of 

that practice is palliative, prophylactic, etc., and 

*See Stille's Therapeutics and Materia Medica, fourth 
9dition, vol II, p. 742. 



AN ADDRESS TO SOME STUDENTS. 133 

has nothing to do with homoeopathy. Furthermore, 
in our efforts at curative treatment we may in a 
given case, because of errors in our records of 
materia medica pura, use as homoeopathic a medi- 
cine which really is not homoeopathic. Doubtless 
the errors in our records of materia medica pura are 
very many: you may be sure that provers have even 
attributed pathogenetic properties to some sub- 
stances which are not pathogenetic agents,* and it 
would be well for you to understand that the truth 
of sii7iilia does not depend upon the accuracy of 
provers. When, in your investigation of the prin- 
ciple, homoeopathy, you scrutinize the practice of a 
homoeopathist in a given case, you will do well to 
first determine whether that practice is intended as 
homoeopathic; and, if it is so intended, to next deter- 
mine, by a study of disease effects manifested in the 
patient and a study of drug pathogenesy, whether the 
practice intended as homoeopathic really is homoeo- 
pathic; and, if it really is homoeopathic, to then 
determine in what degree it is homoeopathic, f I be- 
lieve that homoeopathy is without flaw, and that you 
will find it much more profitable to study homoeo- 
pathy than to study homoeopathists. 

* See pp. 39 and 40 of this book. 

f See what is said on p. 24 of this book as to the signifi- 
cance of similar' s being a comparable adjective. 



